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Sample records for mandibular condyle fracture

  1. Mandibular Condyle Fractures and Treatment Modalities

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    Halil ibrahim Kisa

    2014-08-01

    Full Text Available Maxillofacial injuries are most commonly associated with falls, motor and vehicle accidents, sports-related trauma, and interpersonel violence. The complexity of mandibular condyle region and its anatomic proximity to other craniofacial structures complicate diagnosis and treatment. Thus, treatment approaches of mandibular condyle fracture are still controversial. In the literature, different success rates are reported about observation versus treatment, closed reduction versus open reduction and fixation methods. In the present article, controversial issues related to mandibular condyle fractures were reviewed under the light of current literature. In conclusion, the simplest way that can be done with the least risk of complication should be chosen during treatment planning. In addition, current adjunctive treatment methods accelerating healing of fracture should be considered. [Archives Medical Review Journal 2014; 23(4.000: 658-671

  2. The application of the Risdon approach for mandibular condyle fractures

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    Nam, Seung Min; Lee, Jang Hyun; Kim, Jun Hyuk

    2013-01-01

    Background Many novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated. Methods A review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 sub...

  3. Function impairment and pain after closed treatment of fractures of the mandibular condyle

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    Dijkstra, P.U.; Stegenga, B.; de Bont, L.G.; Bos, R.R.

    2005-01-01

    Background: To determine the prognosis of fractures of the mandibular condyle after closed treatment. Methods: Patients (n = 144) with a fracture of the mandibular condyle, all treated closed, were included in the study. Fracture types and position of the fracture parts were determined on radiograph

  4. Function impairment and pain after closed treatment of fractures of the mandibular condyle

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    Dijkstra, P.U.; Stegenga, B.; de Bont, L.G.; Bos, R.R.

    Background: To determine the prognosis of fractures of the mandibular condyle after closed treatment. Methods: Patients (n = 144) with a fracture of the mandibular condyle, all treated closed, were included in the study. Fracture types and position of the fracture parts were determined on

  5. Unerupted lower third molars and their influence on fractures of the mandibular angle and condyle.

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    Patil, Pavan M

    2012-07-01

    Our aim was to assess the influence of the presence and state of impaction of mandibular third molars on the incidence of fractures of the mandibular angle and condyle. We designed a retrospective study of patients who presented for the treatment of mandibular fractures from January 2006 to April 2011. The independent variables were the presence and degree of impaction of lower third molars, and the outcome variables were the incidence of fractures of the mandibular angle and condyle. The information was acquired from hospital records and panoramic radiographs. Personal data included age, sex, mechanism of injuries, and number of fractures of the mandibular angle and condyle. We studied 110 fractures of the mandibular condyle and 80 of the angle. The incidence of fractures of the mandibular angle was higher in the group with incompletely erupted third molars (37/80, pthird molar reduces the risk of condylar fractures and increases the risk of fractures of the mandibular angle.

  6. [Our physiotherapy treatment of articular fractures of the mandibular condyle].

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    Lemière, E; Sicre, A; Vereecke, F; Brygo, A; Nicola, J; Ferri, J

    2003-04-01

    Physical therapy greatly contributes to improved function of the injured temporomandibular joint, particularly after trauma. In our unit, we use the Delaire rehabilitation method for patients presenting a fracture of the mandibular condyles. This method involves active mobilization, first with assistance, then with facilitation, and finally against resistance. A rehabilitation session starts with a preparation of the teguments and muscles associated with relaxation exercises. The joint is first mobilized by assisted movements if needed. When unassisted motion becomes possible, propulsion, diduction and open-close exercises are then performed with neuromuscular facilitation. When sufficient amplitudes have been achieved, the program proceeds with opposed exercises. By inducing propulsion and diduction (lateral pterygoid muscle) movements, physical therapy stimulates regeneration of the condylar unit, thus facilitating optimal functional rehabilitation. Posture and passive motion methods, which in our opinion are poorly adapted to the temporomandibular joint, are used little in our unit. Since condylar regeneration is controlled by functional factors, the lateral pterygoid muscle is an important element. Good functional outcome, and the absence of ankylosis, depends directly on the quality of active rehabilitation.

  7. Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

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    Kang-Young Choi

    2012-07-01

    Full Text Available The incidence of condylar fractures is high,but the management of fractures of the mandibularcondyle continues to be controversial. Historically, maxillomandibular fixation, externalfixation, and surgical splints with internal fixation systems were the techniques commonlyused in the treatment of the fractured mandible. Condylar fractures can be extracapsularor intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on theage of the patient, the co-existence of other mandibular or maxillary fractures, whether thecondylar fracture is unilateral or bilateral, the level and displacement of the fracture, thestate of dentition and dental occlusion, and the surgeonnds on the age of the patient, theco-existence of othefrom which it is difficult to recover aesthetically and functionally;anappropriate treatment is required to reconstruct the shape and achieve the function oftheuninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, andcomplication prevention are required. In particular, as mandibular condyle fracture may causelong-term complications such as malocclusion, particularly open bite, reduced posterior facialheight, and facial asymmetry in addition to chronic pain and mobility limitation, great cautionshould be taken. Accordingly, the authors review a general overview of condyle fracture.

  8. Influence of third molars in mandibular fractures. Part 2: mandibular condyle-a meta-analysis.

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    Armond, A C V; Martins, C C; Glória, J C R; Galvão, E L; Dos Santos, C R R; Falci, S G M

    2017-06-01

    The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars in mandibular condyle fractures. An electronic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and VHL, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 13 studies were included in the systematic review and 11 in the meta-analysis. In terms of the risk of bias analysis, six studies presented ≤6 stars in the Newcastle-Ottawa scale assessment. The presence of a mandibular third molar decreased the probability of condylar fracture (cross-sectional and case-control studies: odds ratio (OR) 0.26, 95% confidence interval (CI) 0.17-0.40, I(2)=87.8%; case-control studies: OR 0.30, 95% CI 0.16-0.58, I(2)=91.6%). The third molar positions most favourable to condylar fracture according to the Pell and Gregory classification are class A (OR 1.32, 95% CI 1.09-1.61, I(2)=0%) and class I (OR 1.37, 95% CI 1.05-1.77, I(2)=32.8%). Class B (OR 0.69, 95% CI 0.49-0.97, I(2)=56.0%) and class II (OR 0.71, 95% CI 0.57-0.87, I(2)=0%) act as protective factors for condylar fracture. The results suggest that the presence of a mandibular third molar decreases the chance of condylar fracture and that the positions of the third molar most favourable for condylar fracture are classes A and I, with classes B and II acting as protective factors. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Interpretation of mandibular condyle fractures using 2D- and 3D-computed tomography

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    Costa e Silva Adriana Paula de Andrade da

    2003-01-01

    Full Text Available Computed tomography (CT has been increasingly used in the examination of patients with craniofacial trauma. This technique is useful in the examination of the temporomandibular joint and allows the diagnosis of fractures of the mandibular condyle. Aiming to verify whether the three-dimensional reconstructed images from CT (3D-CT produce more effective visual information than the two-dimensional (2D-CT ones, we evaluated 2D-CT and 3D-CT examinations of 18 patients with mandibular condyle fractures. We observed that 2D-CT and 3D-CT reconstructed images produced similar information for the diagnosis of fractures of the mandibular condyle, although the 3D-CT allowed a better visualization of the position and displacement of bone fragments, as well as the comminution of fractures. These results, together with the possibility of refining and manipulating perspectives in 3D images, reinforce the importance of its use in the surgical planning and evaluation of treatment. We concluded that 3D-CT presented supplementary information for a more effective diagnosis of mandibular condyle fractures.

  10. Condyle and mandibular bone change after unilateral condylar neck fracture in growing rats.

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    Hu, Y; Yang, H-f; Li, S; Chen, J-z; Luo, Y-w; Yang, C

    2012-08-01

    Unilateral fracture of the condylar neck in immature subjects might lead to mandible asymmetry and condyle remodelling. A rat model was used to investigate mandibular deviation and condylar remodelling associated with condyle fracture. 72 4-week-old male rats were randomly divided into three groups: an experimental group (unilateral transverse condylar fracture induced surgically), a sham operation group (surgical exposure but no fracture), and a non-operative control group (no operation). The rats were killed at intervals up to 9weeks after surgery, and outcomes were assessed using various measures of mandible deviation, histological and X-ray observation, and immunohistochemical measures of expression levels of connective tissue growth factor (CTGF) and type II collagen (Col II). The fracture led to the degeneration of mandibular size, associated with atrophy of fractured condylar process. Progressive remodelling of cartilage and increasing expression levels of CTGF and Col II were found. The authors conclude that condylar fracture can lead to asymmetries in mandible and condyle remodelling and expression of CTGF and Col II in condylar cartilage on both the ipsilateral and the contralateral sides.

  11. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

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    Kang-Young Choi

    2012-07-01

    Full Text Available In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.

  12. Aneurysmal bone cyst of the mandibular condyle with condylar neck fracture

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    Park, Jeong Hoon [Department of Biomedical Engineering, College of Medicine and Healthcare Industry Research Institute, Kyung Hee University, Seoul (Korea, Republic of); Yu, Jae Jung; Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Biology, Kyung Hee University, Seoul (Korea, Republic of)

    2009-12-15

    Aneurysmal bone cyst (ABC) is relatively rare, non-neoplastic expansible lesion of bone. The case of a 15-year-old male with a ABC of the left mandibular condyle is presented. Panoramic radiograph showed a unilocular radiolucency with thinned coritces and a subcondylar fracture which was due to the trauma. Computed tomography (CT) revealed expansible lesion which had similar attenuation soft tissue. The patient was treated surgically including iliac crestal bone graft.

  13. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

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    Kang-Young Choi

    2012-07-01

    Full Text Available In the treatment of mandibular condyle fracture, conservative treatment using closedreduction or surgical treatment using open reduction can be used. Management of mandibularcondylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma.For each type of condylar fracture,the treatment method must be chosen taking intoconsideration the presence of teeth, fracture height, patient’sadaptation, patient’s masticatorysystem, disturbance of occlusal function, and deviation of the mandible. In the past, closedreduction with concomitant active physical therapy conducted after intermaxillary fixationduring the recovery period had been mainly used, but in recent years, open treatment ofcondylar fractures with rigid internal fixation has become more common. The objectiveof this review was to evaluate the main variables that determine the choice of an open orclosed method for treatment of condylar fractures, identifying their indications, advantages,and disadvantages, and to appraise the current evidence regarding the effectiveness ofinterventions that are used in the management of fractures of the mandibular condyle.

  14. A new method of CT scanning for the diagnosis of mandibular fractures; A preliminary report: diagnosis of condyle fractures

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    Tsukagoshi, Taku; Satoh, Kaneshige; Onizuka, Takuya (Showa Univ., Tokyo (Japan). School of Medicine)

    1990-08-01

    The condylar neck of the mandible is one of the most common fracture sites in the facial skeleton. Such a fracture is routinely diagnosed by A-P, lateral oblique, and Towne projection roentgenography or orthopantomography. Despite the combination of these films, fracture of the neck of the mandible is still difficult to diagnose definitely. Therefore, a new CT scanning method was developed for diagnosing fractures of the neck of the condylar mandible. The CT axis is projected along the length of the mandible, extending from the condyle to the symphysis. This projection visualizes both the condyle and the mandibular symphysis in the same plane. The patient is placed in a supine position with the head fully extended. The base line, a line extending from the midpoint of the glenoid fossa to the menton, is determined with a lateral facial cephalogram. CT scanning with a 5 mm window is performed in parallel with and 2 cm anterior to and 2 cm posterior to the base line. When CT scanning was performed in a healthy volunteer, the condition of the condyle and the condylar neck of the mandible was clearly shown, and the view extended from the condyle to the symphysis. For automobile accident patients in whom fracture of the neck of the mandible was associated with fracture of the symphysis, two fractures were found in the same plane. A newly developed CT scanning technique is useful in the diagnosis of fractures of the condylar neck of the mandible and in the identification of fractures at other mandibular sites. It also allows scanning of patients in a supine position, which may aid in managing patients with multiple traumas. (N.K.).

  15. Recovery of mouth-opening after closed treatment of a fracture of the mandibular condyle : a longitudinal study

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    Niezen, E. T.; Stuive, I.; Post, W. J.; Bos, R. R. M.; Dijkstra, P. U.

    2015-01-01

    The aim of this retrospective study was to assess recovery of mouth opening after closed treatment of fractures of the mandibular condyle, and analyse which characteristics might influence recovery. We measured mouth opening in 142 patients (mean (SD) age 30 (14) years, 96 of whom were male) during

  16. IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: quality of life aspects

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    van den Bergh, B.; de Mol van Otterloo, J.J.; van der Ploeg, T.; Tuinzing, D.B.; Forouzanfar, T.

    2015-01-01

    Objective Arch bars as treatment for a fractured mandibular condyle are inconvenient to patients and lead to lowered quality of life (QOL). To overcome these inconveniences, IMF-screws (IMFS) to facilitate intermaxillary fixation during surgery have been developed. The purpose of the present study i

  17. Finite element analysis of three patterns of internal fixation of fractures of the mandibular condyle.

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    Aquilina, Peter; Chamoli, Uphar; Parr, William C H; Clausen, Philip D; Wroe, Stephen

    2013-06-01

    The most stable pattern of internal fixation for fractures of the mandibular condyle is a matter for ongoing discussion. In this study we investigated the stability of three commonly used patterns of plate fixation, and constructed finite element models of a simulated mandibular condylar fracture. The completed models were heterogeneous in the distribution of bony material properties, contained about 1.2 million elements, and incorporated simulated jaw-adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. This model was considerably larger and more complex than previous finite element models that have been used to analyse the biomechanical behaviour of differing plating techniques. The use of two parallel 2.0 titanium miniplates gave a more stable configuration with lower mean element stresses and displacements over the use of a single miniplate. In addition, a parallel orientation of two miniplates resulted in lower stresses and displacements than did the use of two miniplates in an offset pattern. The use of two parallel titanium plates resulted in a superior biomechanical result as defined by mean element stresses and relative movement between the fractured fragments in these finite element models.

  18. Eosinophilic granuloma of the mandibular condyle

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    Huh, Kyung Hoe; Yi, Won Jin; Oh, Sung Won; Lee, Sam Sun [Department of Oral and Maxillofacial Radiology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Choi, Mun Kyung [Department of Oral and Maxillofacial Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of)

    2008-03-15

    The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

  19. Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

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    Rajasekhar Gali

    2016-01-01

    Full Text Available Introduction: Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. Purpose: This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible. Patients and Methods: This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a the ease of access for retrieval, reimplantation and fixation of the proximal segment; b the postoperative approach related complications; c the adequacy of anatomical reduction and stability of fixation; d the occlusal changes; and the e TMJ function and radiological changes. Results: Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen. Conclusion: The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby

  20. The role of the lateral pterygoid muscle in the sagittal fracture of mandibular condyle (SFMC) healing process.

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    Liu, Chng-Kui; Liu, Ping; Meng, Fan-Wen; Deng, Bang-Lian; Xue, Yang; Mao, Tian-Qiu; Hu, Kai-Jin

    2012-06-01

    The aim of this study was to examine the role of the lateral peterygoid muscle in the reconstruction of the shape of the condyle during healing of a sagittal fracture of the mandibular condyle. Twenty adult sheep were divided into 2 groups: all had a unilateral operation on the right side when the anterior and posterior attachments of the discs were cut, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. Ten sheep had the lateral pterygoid muscle cut, and the other 10 sheep did not. Sheep were killed at 4 weeks (n=2 from each group), 12 weeks (n=4), and 24 weeks (n=4) postoperatively. Computed tomograms (CT) were taken before and after operations. We dissected the joints, and recorded with the naked eye the shape, degree of erosion, and amount of calcification of the temporomandibular joint (TMJ). In the group in which the lateral peterygoid muscle had not been cut the joints showed overgrowth of new bone and more advanced ankylosis. Our results show that the lateral pterygoid muscle plays an important part in reconstructing the shape of the condyle during the healing of a sagittal fracture of the mandibular condyle, and combined with the dislocated and damaged disc is an important factor in the aetiology of traumatic ankylosis of the TMJ.

  1. Osteochondroma of the mandibular condyle

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    Ashish Kumar

    2011-01-01

    Full Text Available Osteochondroma (OC of the mandibular condyle is a relatively rare condition that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporomandibular joint (TMJ dysfunction, and malocclusion. Radiographically, there is a unilaterally enlarged condyle usually with an exophytic outgrowth of the tumor from the condylar head. We present a case of a left mandibular condylar OC that created a major facial asymmetry, malocclusion, and TMJ dysfunction. Discussion includes the rationale for treatment and the method used in this case. In actively growing OCs, surgical intervention is indicated to remove the tumor stopping the benign growth process and improve facial symmetry, occlusion, and jaw function.

  2. Superolateral dislocation of the intact mandibular condyle associated with panfacial fracture: a case report and literature review.

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    Amaral, Márcio Bruno; Bueno, Sebastião Cristian; Silva, Alice Araújo Ferreira; Mesquita, Ricardo Alves

    2011-06-01

    Superolateral dislocation of the intact mandibular condyle (SDIMC) is rare. This case report focuses on a 15-year-old teenager who was involved in a motor vehicle accident as well a literature review regarding the SDIMC. Clinical examination demonstrated a diffuse edema in the midfacial area and a left lateral deflection of the mandible, including an open bite and a crepitation in the symphyseal region. Three-dimensional computed tomography scans were taken, which presented a superolateral dislocation of the left mandibular condyle as well as panfacial fracture. The patient was set in intermaxillary fixation for 2 weeks and underwent subsequent active jaw physiotherapy, the evaluation of which presented satisfactory results. This case study also presents a literature review, which demonstrated 21 well-documented cases of SDIMC. The patients' mean age was of 29 years. The male gender proved to be more prevalent, with road traffic collisions representing the most common form of accident. Type II, with unilateral dislocation, proved to be the most common. The mean reduction time was 7 days. The open methods were the most commonly used reduction methods. Mandible fracture was associated with dislocation in 82% of the cases, with other facial fractures appearing in only 23% of the cases. Patient follow up presented satisfactory results in 59% of the cases.

  3. IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: Quality of life aspects.

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    van den Bergh, B; de Mol van Otterloo, J J; van der Ploeg, T; Tuinzing, D B; Forouzanfar, T

    2015-09-01

    Arch bars as treatment for a fractured mandibular condyle are inconvenient to patients and lead to lowered quality of life (QOL). To overcome these inconveniences, IMF-screws (IMFS) to facilitate intermaxillary fixation during surgery have been developed. The purpose of the present study is to investigate and compare QOL for patients treated for a fractured mandibular condyle with either IMFS or arch bars. This research trial was conducted from 2010 to 2014 as part of an earlier prospective, multicenter, randomized clinical trial in which the use of IMFS was compared to the use of arch bars in the treatment of mandibular condylar fractures. In total, 50 patients were included: 30 (60%) male patients and 20 (40%) female patients (mean age: 31.8 years, standard deviation [SD] = 13.9 years, range = 18-64 years). A total of 24 (48%) patients were allocated in the IMFS group, and 26 (52%) patients were assigned to the arch-bars control group. Significant results were observed in the subscales social isolation, possibility to eat and vary diet, influence on sleep, and satisfaction with the given treatment, all in favour of IMFS. In conclusion, using IMFS as a method for conservative treatment of condylar fractures led to a higher QOL during the 6-week period of fracture healing. In comparison to arch bars, patients treated with IMFS experienced less social isolation, had fewer problems with eating, and express the feeling they are able to continue their normal diet. Furthermore it seems that the use of IMFS has a lower negative impact on social and financial aspects of the patient. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. Orthodontic treatment of a patient with severe crowding and unilateral fracture of the mandibular condyle.

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    Park, Jae Hyun; Tai, Kiyoshi; Sato, Yasumori

    2016-06-01

    A 15-year-old girl who had a unilateral condylar fracture with severe crowding in both arches was treated with 4 premolar extractions followed by orthodontic therapy with a temporary skeletal anchorage device in the maxillary arch. The total active treatment time was 21 months. Her occlusion was significantly improved by orthodontic treatment, and the range of condylar movement was also improved. Posttreatment records after 30 months showed excellent results with a good stable occlusion. The remodeling process of the condyle was confirmed with cone-beam computed tomography images.

  5. Costochondral graft with green-stick fracture used in reconstruction of the mandibular condyle: experience in 13 clinical cases.

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    Villanueva-Alcojol, Laura; Monje-Gil, Florencio; Gonzalez-Garcia, Raúl; Moreno-Garcia, Carlos; Serrano-Gil, Herminia; Maestre-Rodriguez, Oscar; Ruiz-Laza, Luis; Manzano-Solo de Zaldivar, Damián; Mateo-Arias, Jesús

    2009-12-01

    Since its publication in 1920 by Gillies, costochondral grafts have been used by surgeons to replace and injured mandibular condyle and to reconstruct the temporomandibular joint. This procedure is currently applied in cases of congenital dysplasia, developmental defects, temporomandibular ankylosis, neoplastic disease, osteoarthritis and post-traumatic dysfunction. Over the years, various procedures for the reconstruction with this type of graft have been described. In 1989, Mosby and Hiatt described a technique for setting the graft securely, reducing the space between the graft and the mandibular area. In 1998, Monje and Martín-Granizo developed a variation of this method, enabling a precise adaptation of the costochondral graft to the remaining mandibular ramus. The aim of this study is to evaluate the functional and anatomic results of the costochondral graft treatment by green-stick fracture for reconstruction of the TMJ in the 10 years following the description of this technique. We carry out a retrospective study of thirteen cases of temporomandibular pathology (tumors, ankylosis and hypoplasia) treated during a period of ten years from 1998 to 2008. In all these cases, the technique described by Monje and Martín-Granizo was used: removal of the sixth rib, fixation to a titanium mini-plate using screws, making an internal corticotomy in order to obtain a green-stick fracture of the outer cortex, providing adequate adaptation of the graft to the mandibular ramus. The graft was then set in place, attaching it with titanium screws. This technique was successful in achieving optimal ossification, a good interincisal opening and satisfactory cosmetic results. In conclusion, according to our experience, the green-stick fracture for the adaptation of costochondral grafts to the remaining mandibular ramus has presented outstanding results in the surgical treatment of temporomandibular pathology.

  6. Closed reduction of mandibular condyle fractures using C-arm fluoroscopy: a technical note.

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    Imai, Tomoaki; Michizawa, Masahiro; Yamamoto, Naofumi; Kai, Tatsuro

    2013-01-01

    We describe a C-arm technique for mandibular condylar fractures in an anatomic study using a model skull and show its feasibility in a clinical case. The C-arm allowed posterior-anterior visualization of the condylar process. The X-ray axis was canted ∼15 degrees cranially to the Frankfort horizontal line. The skull's sagittal plane was rotated ∼15 degrees ipsilaterally to the X-ray axis. This technique facilitates clear visualization of the condylar neck with easy, flexible, and timely adjustments. In selected cases, this method would convert the clinical settings of the condylar fracture pattern to that which would not be amenable to an open approach, making possible minimally invasive surgical procedures.

  7. Giant osteochondroma of the mandibular condyle

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    M R Muthu Sekhar

    2015-01-01

    Full Text Available Osteochondroma or osteocartilaginous exostosis is an exophytic lesion that arises from the cortex of the bone and is cartilage-capped. Osteochondroma of the mandibular condyle is extremely rare. The following is a case report of an osteochondroma of the mandibular condyle removed via extended preauricular approach to the temporomandibular joint.

  8. Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

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    Cho, Bong Hae [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    2011-06-15

    The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

  9. Hyperplastic conditions of the mandibular condyles

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    Nah, Kyung Soo [Pusan National University College of Medicine, Busan (Korea, Republic of)

    2003-12-15

    To evaluate the clinical and radiographic features of unilateral hyperplastic mandibular condyles for some useful preliminary diagnostic recommendations. Clinical records, radiographs and histologic diagnoses of 35 cases with asymmetric mandibular condyles due to apparent unilateral condylar hyperplasia were evaluated retrospectively. Among 35 cases, 28 were true hyperplastic conditions of condyles whereas the remaining 7 were unilateral internal derangement occurring on the short side. 17 of the 28 hyperplastic condyles showed a mass or irregular radiographic shadow with histologic diagnosis including osteochondroma and osteoma. Only 5 of these cases showed facial asymmetry. 2 out of ths 17 cases showed hyperplastic round shaped irregular condyles consistent with ankylosis and their histologic diagnoses were osteochondromas. 11 of the 28 cases showed smooth enlargement of condylar head with elongation of the neck causing facial asymmetry, but histologic diagnoses were not available because the surgical operation conserved the condyles. The hyperplastic conditions of the mandibular condyles include not only true hyperplasia, osteochondroma, osteoma, and ankylosis, but also unilateral internal derangement occurring on the short side.

  10. Long-term results and complications after treatment of bilateral fractures of the mandibular condyle

    NARCIS (Netherlands)

    Forouzanfar, T.; Lobbezoo, F.; Overgaauw, M.; de Groot, A.; Kommers, S.; van Selms, M.; van den Bergh, B.

    2013-01-01

    The purpose of this study was to investigate the long-term results of conservative treatment of bilateral condylar fractures and to study the influence of possible functional impairment on intensity of pain and associated disability. We studied 71 patients (mean (SD) age 33 (14) years) with conserva

  11. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  12. BILATERAL BIFID MANDIBULAR CONDYLE WITH TEMPORO-MANDIBULAR JOINT ANKYLOSIS

    Directory of Open Access Journals (Sweden)

    Amit Nandan

    2014-06-01

    Full Text Available We report a case of 10years old female child who presented with presenting complaints of progressive difficulty in jaw opening. The parents gave history of facial trauma suffered five years back. A radiograph obtained at that time was unremarkable. This time she was advised computed tomography (CT examination of temporo-mandibular joint (TMJ to evaluate the severity and extent of ankylosis. Examination was done on a 64 slice CT scanner (GE with isotropic images and additional volume rendered and multiplanar acquisitions. Findings were suggestive of bilateral mediolateral bifid mandibular condyles with fibrous, partial bony ankylosis. Both mandibular condylar head were enlarged with abnormal contour. Condyles were bifid separated by a distinct groove.

  13. Mandibular condyle position in cone beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Hyoung Joo; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [Kyung Hee Univ. School of Dentistry, Seoul (Korea, Republic of)

    2006-06-15

    To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or photoconductors treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. In the sagittal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial, central, and lateral sections. Mandibular condyle within articular fossa in an asymptomatic population was observed non-concentric position in the sagittal and coronal views.

  14. Projection angles of mandibular condyles in panoramic and transcranial radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2006-09-15

    To evaluate the true projection angles of film-side mandibular condyles in panoramic and transcranial radiographs. 52 panoramic and transcranial radiographs of 4 condyles from two human dry mandibles with gradual horizontal and vertical angle changes were taken. The results were compared with the standard panoramic and transcranial radiographs and the identical pairs were selected. Panoramic radiography projected 10 degree to the film-sided condyles both horizontally and vertically. Transcranial radiography projected 15 degree to the film-sided condyles vertically. The medical and lateral poles were not forming the outline of condylar images in both projections when the horizontal angles of condyles were not sufficiently big enough.

  15. Panoramic Image of Mandibular Condyle According to Head Position

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Hwa; Choi, Soon Chul [Dept. of Oral Radiology, College of Dentistry, Seoul National, Seoul (Korea, Republic of)

    1990-08-15

    Panoramic radiography is convenient in clinic and visualizes those areas which other technique do not give. But the technique has limitation of image distortion which results from the relationship of the ramus to the focal trough and from the direction of the central ray. This study is, using 7 dry skulls, to determine the effect of rotation of patient's head on reducing those distortion and determine the magnification ratio of images of mandibular condyle in rotated patient head position. The obtained results were as follows: 1. Generally, in panoramic radiography the anterolateral portion of the mandibular condyle was best to be visualized. 2. There are no significant difference between the image readability of anteromedial portion and that of antercentral portion of the mandibular condyle. 3. Anterolateral portion of the mandibular condyle was better visualized in rotated head position by 20 degree or horizontal condylar inclination than in conventional position or in rotated head position by 10 degree. 4. The magnification ratio of the anteroposterior diameter in the image of mandibular condyle was least in the rotated head position by horizontal inclination of the mandibular condyle and was largest by 20 degree.

  16. [Treatment of fractures of the mandibular condyle. Experiences at the Department of Oral Medicine and Maxillofacial Surgery at Toulon-La-Seyne/Mer].

    Science.gov (United States)

    Ribault, J Y; Lestage, F; Gacon, J; Vittel, P; Roubaudi, G; Pernice, L; Jeannenot, J; Laroche, D; Fourestier, J

    1997-11-01

    The fractures of the gnathic condyle are constantly increasing due to the violent impact on the chine. The functional treatment is essential for good results whereas the restitution of a functional joint, i.e. teeth that engage into one another, is satisfactory for the patient as it can also justify a possible surgical reduction in such cases when significant shifts of fragments resulting from the fractures are present.

  17. Bone changes of mandibular condyle using cone beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Un; Kim, Hyung Seop; Song, Ju Seop; Kim, Kyoung A; Koh, Kwang Joon [Chonbuk National Univ., Chonju (Korea, Republic of)

    2007-09-15

    To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibualr disorder (TMD) patients. 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra-and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Osteopathy (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior surface of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78{sub 0}.84), but interobserver agreement was fair (k=0.45). CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.

  18. 颞下颌关节继发性强直与幼年期髁状突纵行骨折的关系%Relationship between secondary ankylosis of temporomandibular joint and childhood longitudinal fracture of mandibular condyle

    Institute of Scientific and Technical Information of China (English)

    姚军; 周继林; 胡敏; 洪民; 王燕一

    2005-01-01

    论:幼年期髁突纵行骨折对TMJ造成严重继发性损伤,髁突纵行骨折与关节强直关系密切.%BACKGROUND: Much attention has been focused on mandibular condyle fracture, which has long been considered as a severe injury to the temporomandibular joint(TMJ). Restricted by diagnostic methods, many studies have been conducted on transverse fracture whereas little attention has been paid to longitudinal fracture of the mandibular condyle. Even less is known about longitudinal fracture in young children.OBJECTIVE: To evaluate the effects of childhood longitudinal fracture of the mandibular condyle on secondary ankylosis of TMJ.DESIGN: A randomized controlled study.SETTING: Department of Stomatology, General Hospital of Chinese PLA.MATERIALS: The experiment was completed in the Center for Experimental Animals, General Hospital of Chinese PLA. Twelve young Chinese experimental miniature pigs bred by the Institute of Experimental Animals, Beijing Agriculture University, aged 2 -3 months and weighing(5 -5.5) kg, were used and raised with mixed feed, and then divided into 3 groups randomly.METHODS: Food and water was forbidden for the miniature pigs 12 hours before operation. Under anesthesia with(5.0 - 15.0) mg/kg ketamine/xylazine abdominally injected, conventional disinfection was performed in the right lateral decubitus position and layer-by-layer preauricular incisions were made on the left side of the miniature pigs. The joint cyst was incised transversely and the lower cavity of TMJ was exposed and dragged downwards. The mandibular condyle was cleaved into two vertically along the inner 1/3 part of it with a 5.0 mm-wide bone chisel to cause inferior and posterior sagittal fractures. The miniature pigs were executed 3 months and 6 months after operation, and their condyles were cut for observation.MAIN OUTCOME MEASURES:①The morphological changes of mandibular condyle specimens in the three groups observed with the naked eyes.②The pathological

  19. Evaluation of mandibular condyles in children with unilateral posterior crossbite

    Directory of Open Access Journals (Sweden)

    Edson ILLIPRONTI-FILHO

    2015-01-01

    Full Text Available The relationship of mandibular condyle dimensions and its association with unilateral posterior crossbite (UPXB has been suggested in the literature. The purpose of this prospective study was to evaluate mandibular condyles on the left and right sides and between crossed and non-crossed sides in the sagittal and coronal planes, using cone-beam computed tomography (CBCT. Twenty CBCT images of 40 temporo mandibular joints (TMJs in individuals in mixed dentition phase, which included 9 males (mean 7.9 years and 11 females (mean 8.2 years, with unilateral posterior crossbite without premature contacts and functional mandibular shifts and with transverse maxillary deficiency. The criteria for sample exclusion included the presence of painful symptoms, facial trauma history, systemic diseases such as juvenile rheumatoid arthritis, mouth opening limitation (< 40 mm, congenital or genetic anomalies, and skeletal asymmetries that may result in TMJ disorders. Dimensional measurements of the condyles between the right and left sides and crossed and non-crossed sides in sagittal and coronal view were made. There was no significant difference between the measurements of the crossed and non-crossed sides in both sagittal and coronal view. These findings suggest that the presence of unilateral posterior crossbite in children with UPXB did not result in changes between the mandibular condyles in the right and left sides or between the crossed and non-crossed sides in the coronal or sagittal plane.

  20. 78 FR 79308 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    Science.gov (United States)

    2013-12-30

    ... Temporary Mandibular Condyle Prosthesis AGENCY: Food and Drug Administration, HHS. ACTION: Final order... mandibular condyle prosthesis, a preamendments class III device, into class II (special controls), and rename... section 513(b) of the FD&C Act with respect to temporary mandibular condyle prosthesis (the 1997...

  1. Osteochondroma of the mandibular condyle: Report of two surgical approaches.

    Science.gov (United States)

    Lim, William; Weng, Lye Kok; Tin, Goh Bee

    2014-01-01

    Osteochondromas are common tumors of the long bones, but are rare in the craniofacial region. We detailed two different management of osteochondroma of the mandibular condyle treated utilizing three-dimensional (3D) imaging and computer-assisted planning. Simultaneous open temporomandibular joint and orthognathic surgeries were done to treat both the pathology and secondary facial asymmetry. An osteochondroma that presented as a bony mass at the lateral aspect of the left mandibular condyle of a 24-year-old Chinese female was treated with simultaneous orthognathic surgery and conservative excision. No recurrence was detected 7 months postsurgery. An osteochondroma that presented as a generalized enlargement of the right mandibular condyle of a 25-year-old Chinese male was treated with simultaneous orthognathic surgery and condylectomy. There were no significant issues 3 years postsurgery. Simultaneous orthognathic and temporomandibular joint surgeries are a viable option for the management of osteochondroma of the mandibular condyle. The availability of 3D imaging enabled better presurgical examination of the lesion, which directed treatment toward condylectomy or conservative excision.

  2. Recurrent osteochondroma of the mandibular condyle: A case report

    Science.gov (United States)

    Kwon, Young-Eun; Choi, Karp-Shik; An, Chang-Hyeon; Choi, So-Young; Lee, Jae-Seo

    2017-01-01

    A 21-year-old woman presented with facial asymmetry. Crepitus and clicking of the temporomandibular joint were noted. The midline deviated 5.5 mm to the left, and secondary malocclusion was observed. Panoramic and cone-beam computed tomographic images showed an irregular and exophytic bony mass on the anteromedial surface of the right mandibular condyle. A 3-phase bone scan revealed increased tracer uptake on the affected side. The lesion was treated with excision and reshaping under the diagnosis of osteochondroma confirmed by a histopathological examination. The lesion recurred after 3 years, and the patient underwent condylectomy. Mandibular condylar osteochondroma is often resected because it causes functional and aesthetic problems, but it rarely recurs. To the best of our knowledge, only 2 cases of recurrent osteochondromas of the mandibular condyle have been reported previously. Surgical treatment of the osteochondroma should be performed considering the possibility of recurrence, and long-term follow-up is recommended. PMID:28361031

  3. Recurrent osteochondroma of the mandibular condyle: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Young Eun; Choi, Karp Shik; An, Chang Hyeon; Choi, So Young; An, Seo Young [School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of); Lee, Jae Seo [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonnam National University, Gwangju (Korea, Republic of)

    2017-03-15

    A 21-year-old woman presented with facial asymmetry. Crepitus and clicking of the temporomandibular joint were noted. The midline deviated 5.5 mm to the left, and secondary malocclusion was observed. Panoramic and cone-beam computed tomographic images showed an irregular and exophytic bony mass on the anteromedial surface of the right mandibular condyle. A 3-phase bone scan revealed increased tracer uptake on the affected side. The lesion was treated with excision and reshaping under the diagnosis of osteochondroma confirmed by a histopathological examination. The lesion recurred after 3 years, and the patient underwent condylectomy. Mandibular condylar osteochondroma is often resected because it causes functional and aesthetic problems, but it rarely recurs. To the best of our knowledge, only 2 cases of recurrent osteochondromas of the mandibular condyle have been reported previously. Surgical treatment of the osteochondroma should be performed considering the possibility of recurrence, and long-term follow-up is recommended.

  4. The Osteochondroma of the Mandibular Condyle: report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Wook Jin; Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    2000-06-15

    The osteochondroma, also known as osteocartilagenous exostosis, is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones. When present, the tumor is most often reported to affect the mandibular coronoid process. Osteochondroma of the mandibular condyle is extremely rare and may cause signs and symptoms like those seen in patients with temporomandibular joint dysfunction. Sometimes, differentiation between osteochondroma and condylar hyperplasia is not possible on histologic grounds alone, but the radiographic and intraoperative findings together are usually sufficient to establish a definite diagnosis. This report reviews the literature concerning osteochondroma, especially of the maxillofacial region, and describes a case of osteochondroma of the condyle.

  5. Chondrosarcoma of the Mandibular Condyle: A Case Report

    Directory of Open Access Journals (Sweden)

    Keshani F.

    2012-12-01

    Full Text Available Chondrosarcomas are slow-growing, malignant mesenchymal neoplasms characterized by formation of cartilage by the tumoral cells. They display a wide range of morphological features from a well-differentiated growing mass resembling a benign cartilage tumour to a high-grade malignancy with aggressive local invasion. Only 5% to 10% of this neoplasm is confined to the head and neck region. Chondrosarcomas of the mandibular condyle may manifest the typical symptoms of the temporomandibular joint dysfunction syndrome. Tumours of the condyle can reach a large size without producing clinically obvious swellings. A rare case of chondrosarcoma of the mandibular condyle in a 34-years old woman is presented in this report. Patient’s chief complaint was pain in the right temporomandibular joint when her mouth was in a maximum opening position. Mild malocclusion, figured as an occlusal discrepancy, was also detected. Radiographs illustrated erosion in the head of condyle. After condylectomy, the excised mass was histologically diagnosed as a grade II chondrosarcoma.

  6. 内镜辅助开放手术治疗髁突-下颌支联合体骨折%Endoscopy-assisted open treatment for fractures of the mandibular ramus-condyle unit WANG

    Institute of Scientific and Technical Information of China (English)

    王玉良; 左金华; 王芳

    2011-01-01

    目的 探讨内镜技术在手术切开复位内固定治疗髁突-下颌支联合体骨折中的应用.方法16例(18侧)髁突-下颌支联合体骨折患者中,2侧髁颈部骨折,11侧髁颈下骨折,5侧下颌支骨折;6侧髁突骨折段无明显移位,10侧髁突骨折段有明显移位,2侧髁突骨折段脱位.术中经口外入路或经口内入路,在内镜监视下复位移位的骨折段,并利用穿刺套管完成内固定.结果所有患者手术顺利,患者恢复原有的咬合关系,骨折段复位;术后随访12~36个月,关节功能良好、骨折固定稳固、无严重并发症.结论经口内入路或经口外入路内镜辅助手术复位内固定治疗髁突-下颌支联合体骨折具备可行性;该手术方式具有微创和美观等优点.%Objective To describe the use of endoscopic technique for exposure of the mandibular ramus-condyle unit (RCU) to facilitate reduction and rigid fixation of the fractures.Methods Sixteen patients ( 18 sides) with diagnosis of subcondylar fracture ( 11 sides),condylar neck fracture ( 2 sides ),and mandibular ramus fracture (5 sides ),who underwent endoscopic exposure of the RCU and fixation with miniplates by an extraoral or transoral approach.Six sides were no displacement,10 sides were obvious displacement,and 2 sides were dislocation.Results All patients had successful treatment of fractures of the mandibular RCU,all patients showed quick recovery to preinjury occlusion.Followed up 12-36 months,normal temporomandibular joint function was noted in all patients.No patient had marginal mandibular nerve weakness or other complications.Conclusions It demonstrates the feasibility of endoscopic access to the RCU for treatment of the fractures.The procedures can be performed with minimal morbidity and functional impairment.

  7. Assessing the mobility of the mandibular condyle by sonography

    Directory of Open Access Journals (Sweden)

    Chen HY

    2014-10-01

    Full Text Available Han-Yu Chen,1 Shyi-Kuen Wu,1 Chuan-Chin Lu,1,2 Jia-Yuan You,3 Chung-Liang Lai4 1Department of Physical Therapy, Hungkuang University, Taichung, Taiwan; 2Department of Rheumatology, Taichung Hospital, Department of Health, Taiwan; 3Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan; 4Department of Physical Medicine and Rehabilitation, Taichung Hospital, Department of Health, Taiwan Purpose: Traditionally, the measurement of the maximal mouth opening was regarded as the mobility of the temporomandibular joint. The information, however, was not reliable. Sonography was often used to diagnose disc displacement in the temporomandibular joint and its validity was well established. The tool was also appropriate for measuring the outcome of temporomandibular disorders management. Therefore, the purpose of the study was to examine completely the reliability and error for evaluating the mobility of the mandibular condyle by sonography. In addition, the existing methods were modified to improve the repeatability.Patients and methods: The reliability examinations included between-image and within-image explorations to represent the reliabilities of the image capturing and the mobility measuring, respectively. Sixty-two subjects were recruited to receive ultrasonic examination for condylar mobility. The images of the condyle in mouth closing and opening were captured and the horizontal displacement of the condyles was measured as the anterior translation of the condyle. To confirm that the probe did not move during mouth opening, a marker was placed between the skin and the ultrasonic probe as the landmark.Results: The results demonstrated that the intrarater and interrater reliabilities in the within-image test were 0.986 and 0.970 and the reliabilities in the between-image test were 0.904 and 0.857, respectively. The standard errors of measurement in the within-image and between-image tests were 0.04 cm and 0.09 cm, respectively

  8. Complications of mandibular fractures.

    Science.gov (United States)

    Zweig, Barry E

    2009-03-01

    Before any definitive treatment of mandibular fractures, the patient needs to be evaluated for more potentially life-threatening injuries. Complications can and do occur with treatment of mandibular fractures and can occur during any of the phases of treatment. The development of an accurate diagnosis and appropriate treatment plan is vital in achieving optimal success and decreasing complications. Knowledge of the anatomy and the principles of bone healing is also an important factor in preventing complications. To limit long-term untoward effects, complications should be recognized early and the appropriate treatment should be started before a minor complication becomes a complex one that is more difficult to manage.

  9. Radiographic Study of Bony Changes of the Mandibular Condyle

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung A; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology and Institute of Oral Bio Science, School of Dentistry, Chonbuk National University, Chonju (Korea, Republic of)

    2000-03-15

    The purpose of this study is to compare radiographic techniques for the diagnostic accuracy in the detection of osteophytes of the mandibular condyle. A series of bone chips were placed at four locations on the condylar head of a dried human skull. Eight radiographic techniques such as panoramic, transcranial, infracranial, transorbital, reverse-Towne's, submentovertex, multidirectional tomographic and computed tomographic techniques were compared. Three oral radiologists were asked to rate the lesions by four stage score. The statistical analysis was performed by ANOVA test. For the detection of lateral osteophyte, transcranial, infracranial, transorbital and reverse-Towne's views showed superiority. Also, transcranial and infracranial views showed superiority for medial osteophyte. While for the detection of superior and anterior osteophyte, panoramic, transcranial, infracranial, transorbital views showed superiority. Lateral tomograph showed superiority for the detection of superior and anterior osteophyte, but it showed inferiority for lateral and medial osteophte. And antero-posterior tomograph showed superiority for the detection of all osteophytes. Axial computed tomograph showed superiority for the detection of all osteophytes, and coronal computed tomograph showed superiority for lateral, medial and superior osteophytes. While reconstructed sagittal computed tomograph showed relatively superiority for the detection of anterior and superior osteophytes. The conventional radiographs can be used for the detection of bony changes of the mandibular condyle, and tomograph or computed tomograph can be used additionally when it is difficult to detect bony changes on conventional radiographs.

  10. Diagnostic ability of panoramic radiography for mandibular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Jung, Yun Hoa; Cho Bong Hae; Hwang, Dae Seok [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    2010-03-15

    The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral and maxillofacial radiologists (observer A and B), two oral and maxillofacial surgeons (observer C and D), and two general dentists (observer E and F). Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A and B, 93.5% in observer C and D and 80.4% in observer E and F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.

  11. Internal fixation of severely displaced mandibular condylar neck fracture with the aid of ramus osteotomy. A revised technique

    DEFF Research Database (Denmark)

    Hillerup, S

    1997-01-01

    A technique is described whereby the mandibular condyle can be located, replaced and fixed in case of a severely displaced fracture with exarticulation of the condylar head.......A technique is described whereby the mandibular condyle can be located, replaced and fixed in case of a severely displaced fracture with exarticulation of the condylar head....

  12. Treatment of displaced mandibular condylar fracture with botulinum toxin A.

    Science.gov (United States)

    Akbay, Ercan; Cevik, Cengiz; Damlar, Ibrahim; Altan, Ahmet

    2014-04-01

    The aim of this case report is to discuss the effect on condylar reduction of botulinum toxin A treatment used in a child with displaced fracture at condylar neck of mandible. A 3-years old boy was admitted to our clinic for incomplete fracture of mandibular symphysis and displaced condylar fracture at the left side. An asymmetrical occlusal splint with intermaxillary fixation was used instead of open reduction and internal fixation because of incomplete fracture of symphysis and possible complications of condyle surgery. However, it was observed that condylar angulation persisted despite this procedure. Thus, botulinum toxin A was administered to masseter, temporalis and pterygoideus medialis muscles. At the end of first month, it was seen that mandibular condyle was almost completely recovered and that fusion was achieved. In conclusion, Botulinum A toxin injection aiming the suppression of masticatory muscle strength facilitates the reduction in the conservative management of displaced condyle in pediatric patients.

  13. Osteochondroma of the mandibular condyle: Resection and reconstruction using vertical sliding osteotomy of the mandibular ramus.

    Science.gov (United States)

    González-Otero, Sergio; Navarro-Cuéllar, Carlos; Escrig-de Teigeiro, Margarita; Fernández-Alba-Luengo, Javier; Navarro-Vila, Carlos

    2009-04-01

    Osteochondroma is one of the most common benign bone tumours, although not in the craniofacial region. More than half of these appear in the coronoid process. It can appear on the mandibular condyle, especially in its medial half, and mainly affects women aged around forty years. We present the case of a 51-year-old woman with pain of several months' duration in the right temporomandibular joint (TMJ) and no other symptoms. Panoramic radiography showed an enlarged condyle with no subchondral cysts. Computed tomography showed a bony proliferation with benign signs and a scintigraphy revealed an increased uptake in the condyle. Due to the painful clinical symptoms, a surgical procedure using preauricular and retromandibular approaches was performed to excise the condyle. The resulting defect, which was 9 mm high, was reconstructed by means of a vertical sliding osteotomy of the mandibular ramus and two miniplates for osteosynthesis. Almost two years later, the patient is symptom-free and has a normal opening with no malocclusion or deviation in the opening pattern. We present and discuss different reconstruction options after condylectomy.

  14. Central giant cell granuloma of the mandibular condyle: Case-report

    OpenAIRE

    Munzenmayer,J; Tapia, P.; Zeballos,J; Martínez, A.; Compan,Á; Urra, A.; Spencer,ML

    2013-01-01

    This case report describes a 19-year-old female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection and reconstruction with fibula graft. This occurrence is considered very unusual.

  15. Management of fractures of the condyle, condylar neck, and coronoid process.

    Science.gov (United States)

    Kisnisci, Reha

    2013-11-01

    Proper anatomic reduction of the fracture and accelerated complete recovery are desirable goals after trauma reconstruction. Over the recent decades, significant headway in craniomaxillofacial trauma care has been achieved and advancements in the management for the injuries of the mandibular condyle have also proved to be no exception. A trend in operative and reconstructive options for proper anatomic reduction and internal fixation has become notable as a result of newly introduced technology, surgical techniques, and operative expertise.

  16. Mandibular fracture cases in Pelotas, Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Rafael Silva da Silva

    2009-10-01

    Full Text Available 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.

  17. Cone beam computed tomography findings of ectopic mandibular third molar in the mandibular condyle: report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Soo [School of Dentistry, Chosun University, Gwangju (Korea, Republic of)

    2011-09-15

    Impaction of third molar is a common developmental abnormality. However, ectopic impaction of the mandibular third molar in condylar region is an extremely rare condition. This report describes a case of impacted tooth in the mandibular condyle without any associated pathologic condition. Also, this report presents the spatial relationship of the impacted mandibular third molar to the surrounding anatomic structures using cone beam computed tomography.

  18. Multidisciplinary treatment of peripheral osteoma arising from mandibular condyle in patient presenting with facial asymmetry.

    Science.gov (United States)

    Nojima, Kunihiko; Niizuma-Kosaka, Fumiko; Nishii, Yasushi; Sueishi, Kenji; Yamakura, Daiki; Ikumoto, Hideyuki; Ohata, Hitoshi; Inoue, Takashi

    2014-01-01

    While osteomas often occur in the orofacial area, it is relatively rare for one to occur in the temporomandibular joint area. Here, we report a patient who underwent multidisciplinary treatment including high condylectomy for peripheral osteoma arising in the left mandibular condyle. The patient was a 46-year-old woman with the chief complaint of facial asymmetry. Cephalometric analysis revealed skeletal anterior crossbite due to anterior deviation of the mandible, with chin deviation of 10 mm to the right. A computed tomography scan revealed bone hyperplasia in the mesiodistal and inner areas of the left mandibular condyle, which exhibited outward anterior displacement. Bone scintigraphy showed a circular area of strong radioisotope accumulation with indistinct boundaries, consistent with the lesion in the left mandibular condyle. The above findings led to a diagnosis of skeletal mandibular prognathism with facial asymmetry due to peripheral osteoma originating in the left mandibular condyle. After orthodontic treatment and surgical resection of the tumor and mandibular condyle, preservation and prosthetic treatment were undertaken. A well-balanced facial appearance and good occlusion were achieved.

  19. A radiographic study of mandibular condyle shape and position a comparision of trascranial radiograms and individualized corrected tomograms

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Rae; Hwang, Eui Hwang [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    1997-02-15

    The purpose of this study was to observe mandibular condyle shape and position in an asymptomatic population. In order to carry out this study, 142 temporomandibular joints in 71 adults (35 males, 36 females), who were asymptomatic for temporomandibular joint disorders and had no history of prosthodontic or orthodontic treatments, were selected, and rad ideograph using the Accurd-200 head holder (Denar Co., U.S.A.) for lateral individualized corrected tomograms. Mandibular condyles were classified morphologically and evaluated in positional relationships with articular fossae and articular eminences at centric occlusion and 1 inch mouth opening. The obtained results were as follows : 1. In the classification of mandibular condyle shape, the convex type was more prevalent in trascranial radiograms and tomograms taken at medial, central, and lateral locations. 2. In the mandibular condyle position at centric occlusion, the mandibular condyles were placed posterior to the center of articular fossae in trascranial radiograns and anterior to the center of articular fossae in tomograms taken at medi al, central, and lateral locations. 3. In the mandibular condyle position in right and left TMJs at centric occlusion, the mandibular condyles were placed bilateral asymmetric relationships to the articular fossae in trascranial radiograms and tomograms taken at medial, central, and lateral location. 4. In the mandibular condyle position at 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminences in trascranial radiogramas and tomograms taken at central location and posterior to the articular eminences in tomograms taken at medial and lateral locations.

  20. Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Marques, Alexandre Perez; Perrella, Andreia; Arita, Emiko Saito; Pereira, Marlene Fenyo Soeiro de Matos; Cavalcanti, Marcelo de Gusmao Paraiso, E-mail: alexperez34@gmail.co [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Estomatologia

    2010-10-15

    There are many limitations to image acquisition, using conventional radiography, of the temporomandibular joint (TMJ) region. The Computed Tomography (CT) scan is a better option, due to its higher accuracy, for purposes of diagnosis, surgical planning and treatment of bone injuries. The aim of the present study was to analyze two protocols of cone beam computed tomography for the evaluation of simulated mandibular condyle bone lesions. Spherical lesions were simulated in 30 dry mandibular condyles, using dentist drills and drill bits sizes 1, 3 and 6. Each of the mandibular condyles was submitted to cone beam computed tomography (CBCT) using two protocols: axial, coronal and sagittal multiplanar reconstruction (MPR); and sagittal plus coronal slices throughout the longitudinal axis of the mandibular condyles. For these protocols, 2 observers analyzed the CBCT images independently, regarding the presence or not of injuries. Only one of the observers, however, performed on 2 different occasions. The results were compared to the gold standard, evaluating the percentage of agreement, degree of accuracy of CBCT protocols and observers' examination. The z test was used for the statistical analysis. The results showed there were no statistically significant differences between the 2 protocols. There was greater difficulty in the assessment of small-size simulated lesions (drill no.1). From the results of this study, it can be concluded that CBCT is an accurate tool for analyzing mandibular condyle bone lesions, with the MPR protocol showing slightly better results than the sagittal plus coronal slices throughout the longitudinal axis. (author)

  1. Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography

    Directory of Open Access Journals (Sweden)

    Alexandre Perez Marques

    2010-12-01

    Full Text Available There are many limitations to image acquisition, using conventional radiography, of the temporomandibular joint (TMJ region. The Computed Tomography (CT scan is a better option, due to its higher accuracy, for purposes of diagnosis, surgical planning and treatment of bone injuries. The aim of the present study was to analyze two protocols of cone beam computed tomography for the evaluation of simulated mandibular condyle bone lesions. Spherical lesions were simulated in 30 dry mandibular condyles, using dentist drills and drill bits sizes 1, 3 and 6. Each of the mandibular condyles was submitted to cone beam computed tomography (CBCT using two protocols: 1 axial, coronal and sagittal multiplanar reconstruction (MPR; and 2 sagittal plus coronal slices throughout the longitudinal axis of the mandibular condyles. For these protocols, 2 observers analyzed the CBCT images independently, regarding the presence or not of injuries. Only one of the observers, however, performed on 2 different occasions. The results were compared to the gold standard, evaluating the percentage of agreement, degree of accuracy of CBCT protocols and observers' examination. The z test was used for the statistical analysis. The results showed there were no statistically significant differences between the 2 protocols. There was greater difficulty in the assessment of small-size simulated lesions (drill # 1. From the results of this study, it can be concluded that CBCT is an accurate tool for analyzing mandibular condyle bone lesions, with the MPR protocol showing slightly better results than the sagittal plus coronal slices throughout the longitudinal axis.

  2. An unusual cranial dislocation of the mandibular condyle.

    Science.gov (United States)

    Lloyd, Timothy E; Sivarajasingam, Vaseekaran

    2010-04-01

    We report an unusual case of a 20-year-old man who presented with a superolateral dislocation of the left condyle with intracranial penetration following a road traffic accident. Management included open reduction of the condyle, rigid intermaxillary fixation (IMF), and intensive jaw physiotherapy. One year after operation he had good functional outcome with an interincisal opening of 30mm.

  3. Asymmetry of the mandibular condyle in Haida Indians.

    Science.gov (United States)

    Costa, R L

    1986-05-01

    The condyles of 72 aged and sexed Haida Indians were measured for anteroposterior and mediolateral diameter and their approximate areas calculated. Dental wear was assessed for the same individuals. Asymmetry of condyle size did not appear to change with age. In a pair-wise analysis, no relationship was found between the largest of a pair of condyles and the most worn side of the dentition. The difference in size between each pair of condyles (normalized for individual size) was plotted as a histogram and found to have a normal distribution with a mean of 0 and no skewness. Condyle asymmetry does not appear to be related to differential chewing forces but more closely fits the model of fluctuating asymmetry.

  4. [Fracture of the glenoid fossa without mandibular condylar dislocation or fracture: two case reports].

    Science.gov (United States)

    Şahan, Murat; Derin, Serhan; Beydilli, Halil; Çullu, Neşet

    2014-01-01

    The mandibular condyle region which protects the middle cranial fossa from facial and jaw traumas has an excellent osteomuscular structure. Condylar structures reduce or limit the force of trauma. Most importantly, the condylar neck is the weakest part of the mandible and is easily fractured without dislocation. Generally, this mechanism prevents condylar penetration into the middle cranial fossa; however, there are condylar penetration into the middle cranial fossa can be rarely. Glenoid fossa fractures without mandibular condylar fracture and dislocation can be made. In this article, we present two cases to assess the isolated glenoid fossa fractures of the temporal bone.

  5. Diagnostic accuracy of cone beam computed tomography in detection of simulated mandibular condyle erosions

    OpenAIRE

    Shahriar Shahab; Nafiseh Nikkerdar; Maryam Goodarzi; Amin Golshah; Sanaz Sharifi Shooshtari

    2015-01-01

    Introduction: To determine the diagnostic accuracy of cone beam computed tomography (CBCT) in the detection of simulated mandibular condyle erosions. Materials and Methods: Seventeen dry human mandibles were used in this in vitro study. NewTom VG CBCT scanner (New Tom VG, Verona, Veneto region, Italy) was used for the condyles imaging (pre-erosion and post-erosion image). Thirty three lesions were created on the superior (11 cases), anterior (11 cases), and posterior surfaces (11 cases) o...

  6. Animal experimental study on the role of the lateral pterygoid muscles in healing process of the sagittal fracture of mandibular condyles%翼外肌在髁突矢状骨折愈合过程中对髁突形态改建影响的动物实验研究

    Institute of Scientific and Technical Information of China (English)

    刘昌奎; 胡开进; 刘平; 邓天阁; 江欣; 程鹏

    2012-01-01

    目的 观察翼外肌在髁突矢状骨折愈合过程中对髁突形态的改建是否有影响以及是否会进一步导致关节强直的发生.方法 将12只健康成年绵羊随机分为2组,均以右侧颞下颌关节作为手术实验侧,人为手术造成髁突矢状骨折.一组保留翼外肌在髁突内极的附丽,行使其功能,另一组切断翼外肌在髁突内极的附丽,阻断其功能,术后即刻行MRI检查,确定翼外肌是否离断.术后1周对动物模型行CT三维检查,测量髁突骨折块的移位距离及髁突内外径的改变,术后4周、12周及24周时处死动物,再次行CT检查,多平面重建后对髁突形态相关参数测量,以观察髁突的形态变化.结果 通过CT三维测量,两组髁突内外径的改变有明显的差异(P<0.05),证实翼外肌对髁突游离骨折端有牵拉作用,保留翼外肌功能组,对髁突矢状骨折后髁突形态的影响更明显.结论 此动物模型的建立,证实翼外肌对髁突矢状骨折后髁突形态改建的确有影响,为进一步研究“翼外肌牵张成骨在创伤性颞下颌关节强直发生中的作用研究”提供研究平台.%Objective To examine whether they may further cause joint ankylosis lateral pterygoid muscles influence the condyle morphology in the healing process of sagittal fracture of mandibular condyles ( SFMC ) . Methods Twelve healthy adult sheep were included in our study, and all the animals were treated with surgery to make the condyles fracture on the right side of the temporomandibu-lar joint. The animals were randomly divided into two groups: the pterygoids of sheep in one group were cut and not able to function. The others in the other group were not cut. They were still on the internal poles of the fractured condyles and their functions remained. We immediately examined whether the pterygoid muscles were cut ( or not) by MRI after the operation. 3D computed tomograms ( CT) were taken 1,4,12 and 24 weeks after the operation

  7. Post-traumatic bifid mandibular condyle: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Min Ho; Yoon, Kyu Ho; Park, Kwan Soo; Park, Jae An [Dept. of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul (Korea, Republic of)

    2016-09-15

    Bifid mandibular condyle (BMC) is an uncommon morphological variant of the mandibular condyle. Although authors have proposed various etiologies for BMC, no consensus has emerged. In addition, varying findings have been reported regarding the epidemiological parameters of BMC (e.g., prevalence, gender ratio, and age), possibly due to its low incidence. BMC is occasionally associated with symptoms of the temporomandibular joint, such as ankylosis, pain, and trismus; however, it is difficult to detect this condition on conventional radiographs. This study reports a case of BMC with radiographic findings, and reviews the literature on the epidemiology of BMC.

  8. Post-traumatic bifid mandibular condyle: A case report and literature review

    Science.gov (United States)

    Woo, Min-Ho; Yoon, Kyu-Ho; Park, Jae-An

    2016-01-01

    Bifid mandibular condyle (BMC) is an uncommon morphological variant of the mandibular condyle. Although authors have proposed various etiologies for BMC, no consensus has emerged. In addition, varying findings have been reported regarding the epidemiological parameters of BMC (e.g., prevalence, gender ratio, and age), possibly due to its low incidence. BMC is occasionally associated with symptoms of the temporomandibular joint, such as ankylosis, pain, and trismus; however, it is difficult to detect this condition on conventional radiographs. This study reports a case of BMC with radiographic findings, and reviews the literature on the epidemiology of BMC. PMID:27672618

  9. Bifid mandibular condyle with ankylosis in a 3-year-old child: A rare presentation and review

    Directory of Open Access Journals (Sweden)

    Sneedha Mainali

    2010-01-01

    Full Text Available Bifid mandibular condyle with ankylosis is an extremely rare condition and may arise as a developmental or traumatic defect. It may be associated with ankylosis. We here report a case of unilateral bifid mandibular condyle with ankylosis in a 3-year-old child. This is the youngest patient reported with the condition making it one of its first kind in the literature. The detailed description of the case, its radiological findings, and the literature on bifid condyles are reviewed.

  10. Changes in mechanical properties of bone within the mandibular condyle with age.

    Science.gov (United States)

    Huja, Sarandeep S; Rummel, Andrew M; Beck, Frank M

    2008-02-01

    The purpose of the study was to compare indentation modulus (IM) and hardness of condylar bone in young and adult dogs. In addition we desired to examine histologic sections for bone formation activity in the two groups. Mandibular condyles were obtained from adult (1- to 2-year-old) and young (approximately 5-m old) dogs. Two sections/condyle were obtained and one was processed for histomorphometry and the other for mechanical analyses. Indents were made on moist condylar trabecular bone to a depth of 500 nm at a loading rate of 10 nm/s using a custom-made hydration system to obtain IM and hardness. Histomorphometric analyses measured the bone volume/total volume (BV/TV%) and ratio of labeled to unlabeled bone within the condyle. Data were analyzed using a repeated-measures factorial analysis of variance and Tukey-Kramer method. Overall, the IM of the adult condyles (10.0+/-3.4 GPa, Mean+/-SD) were significantly (Pcondylar bone suggested higher bone forming activity than in adult condyles (27.5%). With age there is a change in mass and material properties in the trabecular bone of the mandibular condyle in dogs.

  11. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    Directory of Open Access Journals (Sweden)

    Yeliz Guven

    2015-01-01

    Full Text Available The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case.

  12. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries.

    Science.gov (United States)

    Guven, Yeliz; Zorlu, Sevgi; Cankaya, Abdulkadir Burak; Aktoren, Oya; Gencay, Koray

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case.

  13. 探讨单螺钉内固定治疗下颌骨髁突矢状骨折的临床效果%To investigate the clinical effect of single screw internal fixation in the treatment of mandibular condyle sagittal fracture

    Institute of Scientific and Technical Information of China (English)

    张文兵

    2016-01-01

    目的:分析单螺钉内固定在下颌骨髁突矢状骨折的治疗中的临床效果.方法:收治髁突矢状骨折患者 100例,分两组,各50例.观察组实施单螺钉内固定治疗,对照组实施颌间牵引复位固定治疗.结果:观察组颞下颌关节功能障碍评分和并发症的发生率显著优于对照组(P<0.05).结论:在下颌骨髁突矢状骨折的治疗中,单螺钉内固定可以有效地缓解患者的颞下颌关节功能障碍,减少并发症.%Objective:To analyse the clinical effect of single screw internal fixation in the treatment of mandibular condyle sagittal fracture.Methods:100 patients with sagittal condylar fracture were selected,they were divided into two groups,each in 50 cases.The observation group was treated with single screw internal fixation,and the control group was treated with traction reduction and fixation.Results:The score of the temporomandibular joint dysfunction score and the incidence of complications in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:In the treatment of mandibular condyle sagittal fracture,single screw internal fixation can effectively relieve patients of temporomandibular joint dysfunction, reduce complications.

  14. Bimaxillary orthognathic surgery and condylectomy for mandibular condyle osteochondroma: a case report.

    Science.gov (United States)

    Park, Young-Wook; Lee, Woo-Young; Kwon, Kwang-Jun; Kim, Seong-Gon; Lee, Suk-Keun

    2015-12-01

    Osteochondroma is rarely reported in the maxillofacial region; however, it is prevalent in the mandibular condyle. This slowly growing tumor may lead to malocclusion and facial asymmetry. A 39-year-old woman complained of gradual development of anterior and posterior unilateral crossbite, which resulted in facial asymmetry. A radiological study disclosed a large tumor mass on the top of the left mandibular condyle. This bony tumor was surgically removed through condylectomy and the remaining condyle head was secured. Subsequently, bimaxillary orthognathic surgery was performed to correct facial asymmetry and malocclusion. Pathological diagnosis was osteochondroma; immunohistochemistry showed that the tumor exhibited a conspicuous expression of BMP-4 and BMP-2 but rarely expression of PCNA. There was no recurrence at least for 1 year after the operation. Patient's functional and esthetic rehabilitation was uneventful.

  15. The correlation between mineralization degree and bone tissue stiffness in the porcine mandibular condyle

    NARCIS (Netherlands)

    Willems, N.M.B.K.; Mulder, L.; den Toonder, J.M.J.; Zentner, A.; Langenbach, G.E.J.

    2014-01-01

    The aim of this study was to correlate the local tissue mineral density (TMD) with the bone tissue stiffness. It was hypothesized that these variables are positively correlated. Cancellous and cortical bone samples were derived from ten mandibular condyles taken from 5 young and 5 adult female pigs.

  16. Changed morphology and mechanical properties of cancellous bone in the mandibular condyles of edentate people

    DEFF Research Database (Denmark)

    Ding, Ming

    2004-01-01

    of the mandibular condyles of edentate subjects (n = 25) was compared with that of dentate subjects (n = 24) by means of micro-computed tomography and by the application of Archimedes' principle. Stiffness and strength were determined by destructive mechanical testing. Compared with dentate subjects, it appeared...

  17. Changed morphology and mechanical properties of cancellous bone in the mandibular condyles of edentate people.

    NARCIS (Netherlands)

    Giesen, E.B.W.; Ding, M.; Dalstra, M.; Eijden, T.M. van

    2004-01-01

    Since edentate subjects have a reduced masticatory function, it can be expected that the morphology of the cancellous bone of their mandibular condyles has changed according to the altered mechanical environment. In the present study, the morphology of cylindrical cancellous bone specimens of the ma

  18. 78 FR 9010 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    Science.gov (United States)

    2013-02-07

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Part 872 Dental Devices; Reclassification of... class III, based on the recommendation of a Dental Products Panel (the Panel) meeting on February 11... mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to replace...

  19. Changed morphology and mechanical properties of cancellous bone in the mandibular condyles of edentate people.

    NARCIS (Netherlands)

    Giesen, E.B.W.; Ding, M.; Dalstra, M.; Eijden, T.M. van

    2004-01-01

    Since edentate subjects have a reduced masticatory function, it can be expected that the morphology of the cancellous bone of their mandibular condyles has changed according to the altered mechanical environment. In the present study, the morphology of cylindrical cancellous bone specimens of the

  20. Volumetric analysis of the mandibular condyle using cone beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Bayram, Mehmet, E-mail: dtmehmetbayram@yahoo.com [Karadeniz Technical University, Faculty of Dentistry, Department of Orthodontics, 61080 Trabzon (Turkey); Kayipmaz, Saadettin; Sezgin, Oemer Said [Karadeniz Technical University, Faculty of Dentistry, Department of Oral Radiology, Trabzon (Turkey); Kuecuek, Murat [Karadeniz Technical University, Faculty of Arts and Sciences, Department of Chemistry, Trabzon (Turkey)

    2012-08-15

    Objective: The aim was to determine the accuracy of volumetric analysis of the mandibular condyle using cone-beam computed tomography (CBCT). Materials and methods: Five dry mandibles containing 9 condyles were used. CBCT scans of the mandibles and an impression of each condylar area were taken. The physical volumes of the condyles were calculated as the gold standard using the water displacement technique. After isolating, the condylar volume was sectioned in the sagittal plane, and 0.3 mm thick sections with 0.9 mm intervals were obtained from 3D reconstructions. Using the Cavalieri principle, the volume of each condyle was estimated from the CBCT images by three observers. The accuracy of the CBCT volume measurements and the relation agreements between the results of the three observers were assessed using the Wilcoxon Signed Rank test and Pearson correlation test. The level of statistical significance was set at 0.05. Results: The results of the Pearson correlation showed that there were highly significant positive correlations between the observers' measurements. According to the results of the Wilcoxon Signed Rank test comparing the physical and observers' measurements, there were no statistically significant differences (p > 0.05). Conclusion: The Cavalieri principle, used in conjunction with a planimetry method, is a valid and effective method for volume estimation of the mandibular condyle on CBCT images.

  1. Nonunion of coronal shear fracture of femoral condyle

    Directory of Open Access Journals (Sweden)

    Singh Ajay Pal

    2011-06-01

    Full Text Available 【Abstract】Isolated coronal fractures of femoral condyle are rare in adults and nonunion of Hoffa fracture is reported only a few times in the literature. We analyzed six cases of nonunion of Hoffa fractures over a period of three years. Three patients were treated conservatively and three patients had fixation failures. Delay of presentation was 2 months to one year. Treatment protocol consisted of open reduction, excision of pseudoarthrosis, bone grafting and internal fixation along with knee arthrolysis. Union was achieved in all patients at mean 16 weeks. The treatment of nonunion of Hoffa fractures requires careful preoperative planning and meticulous surgical technique. The literature regarding the controversies in fracture management and surgical technique are reviewed. Key words: Femoral fracture; Fracture fixation, internal; Retrospective studies

  2. Size, shape and age-related changes of the mandibular condyle during childhood

    Energy Technology Data Exchange (ETDEWEB)

    Karlo, Christoph A. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Stolzmann, Paul [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Habernig, Sandra; Kellenberger, Christian J. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Mueller, Lukas [University of Zurich, Clinics for Orthodontics and Paediatric Dentistry, Zurich (Switzerland); Saurenmann, Traudel [University Children' s Hospital Zurich, Department of Rheumatology, Zurich (Switzerland)

    2010-10-15

    To determine age-related differences in the size and shape of the mandibular condyle in children to establish anatomical reference values. A total of 420 mandibular condyles in 210 children (mean age, 7 years) were retrospectively analysed by using computed tomography (CT) imaging. The greatest left-right (LRD) and anterior-posterior (APD) diameters and the anteversion angles (AA) were measured by two readers. An APD/LRD ratio was calculated. The shape of the condyles was graded into three types on sagittal images. Correlations of parameters with the children's age were assessed by using Pearson's correlation analyses. The LRD (mean, 14.1 {+-} 2.4 mm), APD (mean, 7.3 {+-} 1.0 mm) and LRD/APD ratio (mean, 1.9 {+-} 0.3) increased (r{sub LRD} = 0.70, p < 0.01; r{sub APD} = 0.56, p < 0.01; r{sub rat} = 0.28, p < 0.01) while the AA (mean, 27 {+-} 7 ) decreased significantly (r{sub antang} = -0.26, p < 0.001) with age. The condylar shape as determined on sagittal images correlated significantly with age (r = 0.69, p < 0.05). Boys had significantly higher anteversion angles (p < 0.01), greater LRDs (p < 0.05) and greater mean ratios (p < 0.05). The mandibular condyle is subject to significant age-related changes in size and shape during childhood. As the size of the condyles increases with age, the anteversion angles decrease and the shape of the condyle turns from round to oval. (orig.)

  3. 髁突摘除术治疗粉碎性髁突骨折疗效分析%Mandibular condyle ectomy for the treatment of comminuted condylar fracture

    Institute of Scientific and Technical Information of China (English)

    林燕; 程喆; 占适龙; 叶建青; 樊彤海; 刘伟东; 江银华

    2012-01-01

    To investigate the feasibility and indication of condylectomy for treatment of comminuted fractures of the condyle above the neck. METHODS: Sixty—one patients with condylar fractures, treated between September 2007 and September 2011 were reviewed respectively. Among them, 30 underwent open reduction and internal fixation. 15 underwent conservative therapy, and 16 patients (18 sides) who had comminuted fractures of the condyle above the neck underwent conrlyleetomy. AD the patients were followed up for 5 to 48 months after treatment to evaluate (lie outcomes. RESULTS: Among the 16 patients with condylectomy, poor wound healing due to rejection of hemostatie gauze was noted in 1 patient, occlusal deviation occurred in 1 patient, mild mouth opening limitation happened in 1 patient, and anterior open bite was present in 1 patient. The other patients recovered well, without apparent discomfort, malooelusion and facia] asymmetry. CONCLUSIONS: For patients with finished maxillofacial growth, condylectomy is a feasible and effective way for management of comminuted fractures of the condyle. above the neck. Postoperative occlusal deviation, open bite and limited mouth opening can be corrected with further expectant treatment. Supported by Science and Technology Initiation Fund of Lishui People's Hospitai(2012MY12).%目的:探讨髁突颈部以上粉碎性骨折行髁突摘除术的可行性及适应证.方法:回顾我院2007年9月-2011年9月间因外伤导致髁突骨折患者61例,其中完全行手术内固定治疗30例,保守治疗15例,髁突颈部以上粉碎性骨折患者16例(18侧)予以髁突摘除术,术后随访5~48个月,观察疗效.结果:16例(18侧)患者中,止血纱布排异反应导致创口愈合不良1例,咬合偏斜1例,开口轻度受限1例,前牙开(牙合)1例,其余患者无明显咬合不适,牙尖窝关系良好,面容基本对称.结论:对于颌面部发育基本完成的患者,其髁突颈部以上粉碎性骨折采取髁突摘除

  4. 翼外肌对下颌骨髁突矢状骨折后骨折区新骨形成影响的显微CT研究%The role of the lateral pterygoid muscle in the new bone formation in the sagittal fractured mandibular condyle examined by Micro-CT

    Institute of Scientific and Technical Information of China (English)

    江欣; 胡开进; 邓天阁; 刘昌奎; 薛洋; 刘平; 程鹏

    2013-01-01

    Objective: To investigate the role of the lateral pterygoid muscle in the new bone formation during healing of sagittal fracture of the mandibular condyle. Methods: Oblique sagittal fracture on the right condyle of 24 adult sheep was made by osteotomy. In the control group(n = 12) the lateral pterygoid muscle was cut, and in the experimental(n= 12) was not. 4 sheep were killed at 4, 12 and 24 weeks after operation respectively. Three-dimensional reconstruction was performed by micro-CT, the tra-becula number (Tb. N) , trabecula thickness ( Tb. Th) , trabecula space (Tb. Sp) and bone volume fraction ( BV/TV ) of the fractured condyles were measured, the data were analyzed by SPSS 13. 0. Results: The shape of condyle was changed more in the experimental group than in the control. In the experimental group Tb. N, Tb. Th and BV/TV increased (P 0. 05 ) . Conclusion: The lateral pterygoid muscle can promote the new bone formation in the reconstruction of the mandibular condyle during healing of sagittal fracture.%目的:观察翼外肌在颞下颌骨髁突矢状骨折愈合时新骨形成中的作用.方法:24只绵羊随机分为2组,每组各12只,实验组:髁突截骨术造成绵羊右侧髁突矢状骨折,保留翼外肌;对照组:髁突截骨术造成绵羊右侧髁突矢状骨折,离断翼外肌.分别于术后4、12、24周3个时间点实验组及对照组各处死4只动物,进行显微CT(Micro-CT)扫描,观察分析骨折区新生骨的骨小梁数量(trabecula number,Tb.N),骨小梁厚度(trabecula thickness,Tb.Th),骨体积分数(bone volumefraction,BV/TV)及骨小梁间隙宽度(trabecula space,Tb.SP)的变化,并用方差分析法对数据进行统计学分析.结果:实验组髁突形态改变较对照组明显,显微CT图像新生骨小梁结构显示清晰,Tb.N、Tb.Th、BV/TV增加(P<0.05),Tb.Sp减小(P<0.05),组间比较差异均具有统计学意义(P<0.05),对照组各参数变化无统计学意义(P>0.05).结论:翼外肌在颞下颌关

  5. Femoral Condyle Fracture during Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Selahattin Ozyurek

    2015-07-01

    Full Text Available Dear Editor,We have greatly enjoyed reading the case report entitled “‘Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature in the issue of Arch Bone Jt Surg. 2015;3(2 with great interest. We would like to commend the authors for their detailed and valuable work. Although various case reports have described postoperative distal femur fracture at a range of time intervals (1,2 intraoperative intra-articular distal femur fracture is a unique entity.However, we believe that some important additional observations seem necessary to be contributed through this study. In this article, the authors stated that, to the best of their knowledge, there is no other case report in the literature introducing a femoral condyle fracture during arthroscopic ACL reconstruction or revision reconstruction. Nevertheless, we would like to call the attention of the readers to the fact that that the literature contains one additional case report re‌porting on intraoperative distal femoral coronal plane (Hoffa fracture during primary ACL reconstruction (2. Werner BC and Miller MD presented of case report of an intraoperative distal femoral coronal plane (Hoffa fracture that occurred during independent femoral tunnel drilling and dilation in a primary ACL reconstruction. As in the their case, this type of fracture can occur with appropriately placed femoral tunnels, but the risk can increase with larger graft diameters in patients with smaller lateral femoral condyles The patient was treated with open reduction and internal fixation, without compromise of graft stability and with good recovery of function. We believe that tailoring graft size to the size of the patient is important to prevent similar adverse events.

  6. Static and dynamic loading of mandibular condyles and their positional changes after bilateral sagittal split advancement osteotomies

    NARCIS (Netherlands)

    Dicker, G.J.; Tuijt, M.; Koolstra, J.H.; van Schijndel, R.A.; Castelijns, J.A.; Tuinzing, D.B.

    2012-01-01

    This study analysed the effects of change of direction of masseter (MAS) and medial pterygoid muscles (MPM) and changes of moment arms of MAS, MPM and bite force on static and dynamic loading of the condyles after surgical mandibular advancement. Rotations of the condyles were assessed on axial MRIs

  7. Diagnostic accuracy of cone beam computed tomography in detection of simulated mandibular condyle erosions

    Directory of Open Access Journals (Sweden)

    Shahriar Shahab

    2015-01-01

    Full Text Available Introduction: To determine the diagnostic accuracy of cone beam computed tomography (CBCT in the detection of simulated mandibular condyle erosions. Materials and Methods: Seventeen dry human mandibles were used in this in vitro study. NewTom VG CBCT scanner (New Tom VG, Verona, Veneto region, Italy was used for the condyles imaging (pre-erosion and post-erosion image. Thirty three lesions were created on the superior (11 cases, anterior (11 cases, and posterior surfaces (11 cases of the condyles. The pre- and post-erosion images were randomly presented to two previously calibrated oral and maxillofacial radiologists in order to evaluate the presence of simulated erosions and their position in the condyles using two protocols. In the first protocol, axial and coronal images and in the second protocol, axial, coronal, and sagittal/multiplanar reconstructed (MPR images were used to evaluate the lesions of the samples. Furthermore, the Cochran′s Q test and McNemar and Kappa statistical tests were used to assess the sensitivity, specificity, and accuracy of this study. Results: There was no statistically significant difference between the diagnostic methods and the reference value. There was substantial agreement between the two protocols (Kappa > 0.61. Protocol 2 showed relatively better results than protocol 1 but the difference was not statistically significant (P > 0.05. Sensitivity, specificity, and diagnostic accuracy levels in the erosion imaging were higher in the posterior region of condyle; however, there was no statistically significant difference between the condylar regions (P > 0.05. Conclusion: CBCT had high sensitivity, specificity, and diagnostic accuracy in the detection of simulated mandibular condyle erosions.

  8. Nonunion of coronal shear fracture of femoral condyle

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Ish Kumar Dhammi; Raju Vaishya; Anil Kumar Jain; Arun Pal Singh; Prashant Modi

    2011-01-01

    Isolated coronal fractures of femoral condyle are rare in adults and nonunion of Hoffa fracture is reported only a few times in the literature. We analyzed six cases of nonunion of Hoffa fractures over a period of three years. Three patients were treated conservatively and three patients had fixation failures. Delay of presentation was 2 months to one year. Treatment protocol consisted of open reduction, excision of pseudoarthrosis, bone grafting and internal fixation along with knee arthrolysis. Union was achieved in all patients at mean 16 weeks. The treatment of nonunion of Hoffa fractures requires careful preoperative planning and meticulous surgical technique. The literature regarding the controversies in fracture management and surgical technique are reviewed.

  9. The anatomical relationship between the position of the auriculotemporal nerve and mandibular condyle.

    Science.gov (United States)

    Fernandes, Paulo R B; de Vasconsellos, Henrique A; Okeson, Jeffrey P; Bastos, Ricardo L; Maia, Mey L T

    2003-07-01

    Head, neck, face, and ear pains are commonly associated with disorders of the temporomandibular joint (TMJ). Several theories have been proposed regarding the functional relationship of the TMJ and the associated structures, and how they might contribute to certain painful conditions. This study was conducted to determine the anatomic relationship of the auriculotemporal nerve to the middle meningeal artery and the mandibular condyle. Forty human cadaver temporomandibular joints were dissected to locate the precise position of the auriculotemporal nerve to the mandibular condyle. The study findings revealed a significant variation in the relationship of the auriculotemporal nerve to the middle meningeal artery. The auriculotemporal nerve was found to be between 10-13 mm inferior to the superior surface of the condyle and 1-2 mm posterior to the neck of the condyle. The nerve was not found to be in a position that would likely create an entrapment with adjacent tissues. These findings may assist the clinician to locate the most appropriate injection site for an auriculotemporal nerve block.

  10. Occipital condyle fracture as a rare cause of shoulder pain

    Directory of Open Access Journals (Sweden)

    Anil Yalcin

    2015-06-01

    Full Text Available Occipital condyle fractures (OCFs usually occur due to high energy trauma and are often associated with serious injuries, particularly in the brain. Because it is difficult to determine this fracture on plain radiographs, it can easily be misdiagnosed. In this report, we present a patient admitted to our emergency department with one and only complaint of shoulder pain following a motor vehicle accident. We aimed to underline the importance of physician’s elaboration and attention in the diagnosis of this rare entity.

  11. Bifid mandibular condyle with temporomandibular joint ankylosis: report of two cases and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Gulati, Ajay; Virmani, V.; Ramanathan, S.; Khandelwal, N. [Postgraduate Institute of Medical Education and Research, PGIMER, Department of Radiodiagnosis and Imaging, Chandigarh (India); Verma, L. [Gian Sagar Dental College and Hospital, Department of Pedodontics, Patiala (India)

    2009-10-15

    Bifid mandibular condyle is an uncommon entity with a controversial etiology. It can be developmental or acquired and rarely may be associated with temporomandibular joint (TMJ) ankylosis. Although the patient may be asymptomatic, the radiologist should be aware of this entity and its clinical implications. We report two cases of BMC, one developmental and the other secondary to trauma. Both were diagnosed using computed tomography, which additionally revealed the associated ankylosis of TMJ in both the patients. (orig.)

  12. Proliferative periostitis of the mandibular ramus and condyle: a case report

    OpenAIRE

    Seok, Hyun; Kim, Seong-Gon; Song, Ji-Young

    2015-01-01

    Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an acc...

  13. Proliferative periostitis of the mandibular ramus and condyle: a case report.

    Science.gov (United States)

    Seok, Hyun; Kim, Seong-Gon; Song, Ji-Young

    2015-08-01

    Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an accurate differential diagnosis was important for proper treatment.

  14. Nontraumatic bifid mandibular condyles in asymptomatic and symptomatic temporomandibular joint subjects

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae; Jung, Yun Hoa [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan (Korea, Republic of)

    2013-03-15

    This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.

  15. Occipital condyle fractures: report of five cases and literature review.

    Science.gov (United States)

    Caroli, Emanuela; Rocchi, Giovanni; Orlando, Epimenio Ramundo; Delfini, Roberto

    2005-06-01

    Occipital condyle fractures (OCFs) are uncommon and potentially fatal lesions. After the advent of CT, prompt diagnosis can be readily made and consequently better prognosis of these patients is expected. Early recognition of some types of OCF is imperative to avoid fatal results. We analyzed 121 cases of OCF (116 from the literature and five of our own). Rarely patients with a deficit of the lower cranial nerves make a complete recovery. However, quoad vitam prognosis of patients with "pure OCFs" remains good. Immobilization provides good recovery of most OCFs, but delay of treatment can lead to serious morbidity. We want to emphasize that not only an OCF with instability of O-C1-C2 can be a fatal injury unless prompt surgical intervention, but a displacement and migration of the fractured condylar fragment can also result in a fatal outcome. A high level of suspicion is fundamental for the early diagnosis of these fractures, so that when a posterior basal cranial or occipital squama fracture occurs, a CT study of the occipital condyles becomes imperative.

  16. [The Helkimo index for assessing treatment results after mandibular fractures].

    Science.gov (United States)

    Härtel, J; Hellmuth, M; Hellmuth, K O

    1991-01-01

    Based on the Helkimo index we assessed the success of conservative and conservative-surgical forms of treatment for mandibular fractures in a total of 166 patients. The control group consisted of 50 probands. The Helkimo dysfunction index, which is based on various criteria, showed dysfunction in 81.9% of the patients with only slight functional impairment in 57.2% of these cases. 18.1% of the patients were clinically symptom-free. A comparison with the probands revealed no major differences in dysfunction between the two groups. Significant differences were observed only in the case of 2 isolated criteria (maximum mandibular protrusion, muscle pain). Severe dysfunction, however, was more common in the fracture patients. Based on the Helkimo occlusion index disorder were noted in 91.7% of the patients, while severe occlusion disorder were observed particularly in patients with combined mandibular body and condyle fractures (40.0%). In the control group a more favorable occlusion index was found to be due mainly to the greater number of present and/or occluding teeth. The Helkimo index, particularly the dysfunctionindex, is a very useful instrument for assessing the success of treatment measures in mandibular fracture cases. It should be more commonly used to improve the possibilites of objective comparisons between patients from different hospitals.

  17. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    OpenAIRE

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a frac...

  18. Intra- and interobserver agreement of computed tomography in assessment of the mandibular condyle

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae; Jung, Yun Hoa [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2007-12-15

    To study the intra- and interobserver agreement of multidetector row computed tomography (MDCT) in interpretation of degenerative changes of the mandibular condyle. Five observers independently evaluated one hundred temporomandibular joint MDCT images for signs of osteophytes, erosion, sclerosis and flattening. The intra- and interobserve agreements were calculated by using Kappa statistics. The intraobserver agreement was substantial for erosion (k=0.75), flattening (k=0.74) and sclerosis (k=0.72) and almost perfect for osteophytes (k=0.84). The interobserver agreement was fair for flattening (k=0.39), moderate for erosion (k=0.58) and sclerosis (k=0.48) and substantial for osteophytes (k=0.75). This study shows that we can expert good agreement for the presence of osteophytes, but not for flattening in the interpretation of MDCT images of the condyle.

  19. Effect of the interaction between periodontitis and type 1 diabetes mellitus on alveolar bone, mandibular condyle and tibia.

    Science.gov (United States)

    Kim, Ji-Hye; Lee, Dong-Eun; Gunawardhana, K S Niluka Darshani; Choi, Seong-Ho; Woo, Gye-Hyeong; Cha, Jeong-Heon; Bak, Eun-Jung; Yoo, Yun-Jung

    2014-05-01

    This study examined the effect of the interaction between periodontitis and type 1 diabetes mellitus on alveolar bone, mandibular condyle and tibia in animal models. Rats were divided into normal, periodontitis, diabetic and diabetic with periodontitis groups. After injection of streptozotocin to induce diabetes, periodontitis was induced by ligation of both lower-side first molars for 30 days. Alveolar bone loss and trabecular bone volume fraction (BVF) of the mandibular condyle and tibia were estimated via hematoxylin and eosin staining and micro-computed tomography, respectively. Osteoclastogenesis of bone marrow cells isolated from tibia and femur was assayed using tartrate-resistant acid phosphatase staining. The cemento-enamel junction to the alveolar bone crest distance and ratio of periodontal ligament area in the diabetic with periodontitis group were significantly increased compared to those of the periodontitis group. Mandibular condyle BVF did not differ among groups. The BVF of tibia in the diabetic and diabetic with periodontitis groups was lower than that of the normal and periodontitis groups. Osteoclastogenesis of bone marrow cells in the diabetic groups was higher than that in the non-diabetic groups. However, the BVF of tibia and osteoclastogenesis in the diabetic with periodontitis group were not significantly different than those in the diabetic group. Type 1 diabetes mellitus aggravates alveolar bone loss induced by periodontitis, but periodontitis does not alter the mandibular condyle and tibia bone loss induced by diabetes. Alveolar bone, mandibular condyle and tibia may have different responses to bone loss stimuli in the diabetic environment.

  20. Role of the Lateral Pterygoid Muscle in the Sagittal Fracture of Mandibular Condyle (SFMC) Healing Process%翼外肌在髁突矢状骨折愈合过程中对髁突形态改建的影响

    Institute of Scientific and Technical Information of China (English)

    刘平; 刘昌奎; 邓天阁; 江欣; 程鹏; 胡开进

    2012-01-01

    Objective: To examine the effect of the lateral peterygoid muscle in the reconstruct the condylar shape during the sagittal fracture of mandibular condyle (SFMC) healing process. Methods: Twenty梖our adult sheep were divided into 2 groups . All sheep had a unilateral operation on the right side of cuting anterior and posterior attachments of the the discs, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. One group (groupl) of twelve sheep's lateral pterygoid muscle were cut. The other group (group2) weren't cut the lateral pterygoid muscle. Each group sheep was sacrificed at 4 weeks (2 sheep) , 12 weeks (4 sheep), and 24 weeks (4 sheep) after surgery. Computed tomograms (CT) were taken after sacrificed, and the three imensional compute tomographic reconstruction was used to observe condylar shape. Results: In the group without cut the lateral peterygoid muscle, the joints showed greater overgrows of new bone and more advanced ankylosis. Conclusion: This study shows that the lateral pterygoid muscle plays an important part in reconstructing the condylar shape during the sagittal fracture of mandibular condyle (SFMC) healing process.%目的:本实验的目的是检查翼外肌在髁突矢状骨折愈合过程中,对髁突形态改建的影响.方法:20只1岁龄成年绵羊,随机分为两组,每组10只动物,所有绵羊都用超声骨刀造成髁突矢状骨折,剪断关节盘前后附着并将其推向内侧,其中组1动物切断翼外肌,组2动物保留翼外肌功能.每组动物分别在术后4周(各2只)、12周(各4只)、24周(各4只)处死.处死后行CT检查,CT三维重建观察髁突形态,并解剖颞颌关节(TMJ)以观察髁突形态.结果:组2即保留翼外肌功能组,较组1髁突有更多新骨形成,髁突形态改变更严重.结论:翼外肌在髁突矢状骨折愈合过程中对髁突形态改建的影响起非常重要的作用.

  1. Bone and cartilage changes in rabbit mandibular condyles after a single injection of botulinum toxin

    Science.gov (United States)

    Matthys, Tori; Ho Dang, Hong An; Rafferty, Katherine L.; Herring, Susan W.

    2015-01-01

    Introduction Temporary paralysis of the masseter muscle using botulinum toxin is a common treatment for temporomandibular disorders, bruxism, and muscle hypertrophy. Loss of masseter force is associated with decreased mandibular mineral density. Our objectives were (1) to establish whether bone loss at the mandibular condyle is regionally specific, and (2) to ascertain whether the treatment affects the condylar cartilage. Methods Young adult female rabbits received a unilateral masseter injection of botulinum neurotoxin serotype A (BoNT/A, n=31), saline (n=19) or no injection (n=3) and were also injected with bromodeoxyuridine (BrdU), a replication marker. Termination occurred 4 or 12 weeks following treatment. Condyles were processed by paraffin histology. Cortical thickness, cartilage thickness and trabecular bone areal density were measured, and replicating cells were counted after BrdU reaction. Results BoNT/A rabbits exhibited a high frequency of defects in the condylar bone surface, occurring equally on injected and uninjected sides. Bone loss was seen only on the side of the BoNT/A injection. Cortical as well as trabecular bone was severely affected. The midcondylar region lost the most bone. Recovery at 12 weeks was insignificant. Condylar cartilage thickness showed no treatment effect but did increase with time. Numbers of proliferating cells were similar in treatment groups, but BoNT/A animals showed more side asymmetry in association with the condylar defects. Conclusion Bone loss may be a risk factor for the use of botulinum toxin in jaw muscles. PMID:26672706

  2. Static and dynamic loading of mandibular condyles and their positional changes after bilateral sagittal split advancement osteotomies.

    Science.gov (United States)

    Dicker, G J; Tuijt, M; Koolstra, J H; Van Schijndel, R A; Castelijns, J A; Tuinzing, D B

    2012-09-01

    This study analysed the effects of change of direction of masseter (MAS) and medial pterygoid muscles (MPM) and changes of moment arms of MAS, MPM and bite force on static and dynamic loading of the condyles after surgical mandibular advancement. Rotations of the condyles were assessed on axial MRIs. 16 adult patients with mandibular hypoplasia were studied. The mandibular plane angle (MPA) was 39° in Group II (n=8). All mandibles were advanced with a bilateral sagittal split osteotomy (BSSO). In Group II, BSSO was combined with Le Fort I osteotomy. Pre and postoperative moment arms of MAS, MPM and bite force were used in a two-dimensional model to assess static loading of the condyles. Pre and postoperative data on muscle cross-sectional area, volume and direction were introduced in three-dimensional dynamic models of the masticatory system to assess the loading of the condyles during opening and closing. Postsurgically, small increases of static condylar loading were calculated. Dynamic loading decreased slightly. Minor rotations of the condyles were observed. The results do not support the idea that increased postoperative condylar loading is a serious cause for condylar resorption or relapse.

  3. Comparison of accuracy of uncorrected and corrected sagittal tomography in detection of mandibular condyle erosions: An exvivo study

    Directory of Open Access Journals (Sweden)

    Asieh Zamani Naser

    2010-01-01

    Full Text Available Background: Radiographic examination of TMJ is indicated when there are clinical signs of pathological conditions, mainly bone changes that may influence the diagnosis and treatment planning. The purpose of this study was to evaluate and to compare the validity and diagnostic accuracy of uncorrected and corrected sagittal tomographic images in the detection of simulated mandibular condyle erosions. Methods : Simulated lesions were created in 10 dry mandibles using a dental round bur. Using uncorrected and corrected sagittal tomography techniques, mandibular condyles were imaged by a Cranex Tome X-ray unit before and after creating the lesions. The uncorrected and corrected tomography images were examined by two independent observers for absence or presence of a lesion. The accuracy for detecting mandibular condyle lesions was expressed as sensitivity, specificity, and validity values. Differences between the two radiographic modalities were tested by Wilcoxon for paired data tests. Inter-observer agreement was determined by Cohen′s Kappa. Results: The sensitivity, specificity and validity were 45%, 85% and 30% in uncorrected sagittal tomographic images, respectively, and 70%, 92.5% and 60% in corrected sagittal tomographic images, respectively. There was a significant statistical difference between the accuracy of uncorrected and corrected sagittal tomography in detection of mandibular condyle erosions (P = 0.016. The inter-observer agreement was slight for uncorrected sagittal tomography and moderate for corrected sagittal tomography. Conclusion: The accuracy of corrected sagittal tomography is significantly higher than that of uncorrected sagittal tomography. Therefore, corrected sagittal tomography seems to be a better modality in detection of mandibular condyle erosions.

  4. Architectural measures of the cancellous bone of the mandibular condyle identified by principal components analysis

    DEFF Research Database (Denmark)

    Giesen, EB; Ding, Ming; Dalstra, M

    2003-01-01

    As several morphological parameters of cancellous bone express more or less the same architectural measure, we applied principal components analysis to group these measures and correlated these to the mechanical properties. Cylindrical specimens (n = 24) were obtained in different orientations from...... embalmed mandibular condyles; the angle of the first principal direction and the axis of the specimen, expressing the orientation of the trabeculae, ranged from 10 degrees to 87 degrees. Morphological parameters were determined by a method based on Archimedes' principle and by micro-CT scanning...... analysis revealed four components: amount of bone, number of trabeculae, trabecular orientation, and miscellaneous. They accounted for about 90% of the variance in the morphological variables. The component loadings indicated that a higher amount of bone was primarily associated with more plate...

  5. Osseous alterations in the condylar head after unilateral surgical directional change in rabbit mandibular condyles: preliminary study.

    Science.gov (United States)

    Yang, Hoon Joo; Hwang, Soon Jung

    2014-12-01

    The purpose of this study was to investigate bony changes in the mandibular condyle when the surface not normally subjected to masticatory forces was subjected to functional loading using a unilateral surgical experiment. Fifteen male New Zealand white rabbits, divided into two groups, were used. Oblique vertical body osteotomies of the mandible and counterclockwise rotation (CCWR) of the proximal segment (PS) [six with 1 mm (group I), six with 3 mm (group II)] were performed on the right side. Osseous changes of condyles were analyzed using micro-computed tomography and histological evaluation four weeks postoperatively. The comparison was performed between condyles on the right and left sides. Since the left condyle (control) might be affected by the operation on the right side, the results were also compared with the healthy control (group III, n = 3, 6 condyles). CCWR of the PS led to osteoporotic changes of the condyle including significantly reduced bone volume and bone mineral density (p condylar cartilage and reduced density of cartilaginous cells were observed. However, these changes were not affected by the amount of CCWR of the PS.

  6. A retrospective study of temporomandibular joint ankylosis secondary to surgical treatment of mandibular condylar fractures.

    Science.gov (United States)

    Xiang, Guo-lin; Long, Xing; Deng, Mo-hong; Han, Qian-chao; Meng, Qing-gong; Li, Bo

    2014-03-01

    We investigated the incidence of ankylosis of the temporomandibular joint (TMJ) after open operations for fractures of the mandibular condyle, and analysed possible risk factors in a total of 385 patients with 492 condylar fractures who had been operated on in our department from 2001 to 2010. Sixteen patients developed postoperative ankylosis of the TMJ with 26 joints (5%) affected during a follow-up of 6 months-10 years. Of the 492 condylar fractures, the most common ones that were associated with postoperative ankylosis were those of the condylar head (20/248), followed by the condylar neck (6/193). Subcondylar fractures did not cause postoperative ankylosis (0/51). Among the 16 patients with postoperative ankylosis, 13 had associated anterior mandibular fractures. Long-screw (bicortical screw) fixation of fractures of the condylar head seemed to be associated with a lower incidence of postoperative ankylosis than fixation by miniplate and wire or removal of the fractured fragment. The articular discs were damaged in all ankylosed joints, and the remaining fractured fragment was found in 10 ankylosed joints after fractures of the condylar head. The results suggest that fractures of the condylar head are more prone to lead to postoperative ankylosis of the TMJ, and that the possible risk factors seem to include the technique used for fixation and damage to the disc, together with an anterior mandibular fracture with the fractured fragment remaining.

  7. Comparison of conventional panoramic radiography and panoramic digital subtraction radiography in detection of simulated lesions of mandibular condyle

    Directory of Open Access Journals (Sweden)

    Panjnoush M.

    2008-12-01

    Full Text Available "n  "nBackground and Aim: Digital subtraction Radiography (DSR is a method of accurate assessing condylar head changes. several studies have been carried out in applying DSR in dentistry, however there is a few number of studies in efficacy of DSR method in assesment of condylar head changes, The aim of this study was to compare panoramic radiography and DSR detecting simulated lesions of the mandibular condyl. "nMaterials and Methods: this was a process reaserch study, in which two dry human skulls with no obvious temporomandibular joint pathology were used. Osteophytic lesions were simulated using three sizes of bone chips that were placed on the medial portion of anterior and superolateral aspects of the condyle. Osteolytic lesions were simulated making 1 and 2 mm holes using round burr in the central portion of anterior aspect and Lateral pole of the condyle. Panoramic radiographs were prepared with and without the lesions in place. These paired radiographs were digitized and digital- subtraction images of the original panoramic images were obtained. Eight observers evaluated 155 images of each modality for the presence or absence and the type of simulated lesions of the mandibular condyle. Sensitivity, specificity, reliability and measure of agreement were analyzed using kappa test and crossed tables and qualitative variables were assess by chi-square and fisher's Exact test. "nResults: Specificity of panoramic and DSR methods were 15.4% and 66.7% respectively. Sensitivity of panoramic and DSR methods were 61.1% and 80.6% for osteophytic lesions and 37.5% and 83.3% for Osteolytic lesions. The percentage of correct decisions made in DSR method was significantly more than conventional panoramic method (82.6% vs 41.9% (p<0.0001. "nConclusion: Based on the results of this study digital subtraction technique was significantly more accurate than the panoramic radiographs in detection of simulated lesions of the mandibular condyle.

  8. Subchondral bone loss following orthodontically induced cartilage degradation in the mandibular condyles of rats.

    Science.gov (United States)

    Jiao, Kai; Niu, Li-Na; Wang, Mei-Qing; Dai, Juan; Yu, Shi-Bin; Liu, Xiao-Dong; Wang, Jun

    2011-02-01

    Osteoarthritis (OA) is a degenerative joint disease generally characterized by progressive cartilage degradation and subchondral bone changes. Subchondral bone changes have been proposed to initiate or accompany with cartilage degradation in OA. The purpose of this study was to characterize cartilage damage, subchondral bone remodeling, and the possible mechanism involved in these morphological changes in our reported rat model with OA-like lesions in the mandibular condyle. In experimental groups, the dental occlusion was orthodontically disturbed. By histological analysis, transmission electron microscopy (TEM), micro-CT scanning and serum tests, changes in condylar cartilage and subchondral bone were analyzed at 8 and 12 weeks after treatment. The mRNA and protein levels of bone pro-resorptive and pro-formative factors by chondrocytes were investigated. Increased degraded cartilage areas and obvious cartilage calcification were observed in 8- and 12-week treated (EXP) groups compared to the age-matched controls. Subchondral bone loss, characterized as decreased bone mineral density (BMD), bone volume fraction (BV/TV) and trabecular thickness (Tb.Th), but increased trabecular separation (Tb.Sp), was observed in the 12-week but not the 8-week EXP group, respectively, versus their age-matched controls. The subchondral bone loss in the 12-week EXP group was accompanied with decreased new bone formation rate, but increased serum carboxy terminal telopeptides (CTXs), and increased osteoclast numbers and proportion of surface area in the subchondral bone regions. Increased mRNA and protein levels of M-CSF, VEGF, RUNX and RANKL/OPG ratio, but decreased OPG, were found in condylar cartilage in the 12-week EXP group versus its age-matched controls, and those of RANKL/OPG ratios were significantly higher in the 12-week EXP group than the 8-week EXP. In addition, increased mRNA levels of VEGF, RUNX and RANKL/OPG ratio, but decreased OPG, were also found in condylar

  9. Application of 3-Dimensional Printing Technology to Kirschner Wire Fixation of Adolescent Condyle Fracture.

    Science.gov (United States)

    Dong, Zhiwei; Li, Qihong; Bai, Shizhu; Zhang, Li

    2015-10-01

    Condyle fractures are common in children and are increasingly treated with open reduction. Three-dimensional printing has developed into an important method of assisting surgical treatment. This report describes the case of a 14-year-old patient treated for a right condyle fracture at the authors' hospital. Preoperatively, the authors designed a surgical guide using 3-dimensional printing and virtual surgery. The 3-dimensional surgical guide allowed accurate alignment of the fracture using Kirschner wire without additional dissection and tissue injury. Kirschner wire fixation augmented by 3-dimensional printing technology produced a good outcome in this adolescent condyle fracture. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Dental panoramic image analysis for enhancement biomarker of mandibular condyle for osteoporosis early detection

    Science.gov (United States)

    Suprijanto; Azhari; Juliastuti, E.; Septyvergy, A.; Setyagar, N. P. P.

    2016-03-01

    Osteoporosis is a degenerative disease characterized by low Bone Mineral Density (BMD). Currently, a BMD level is determined by Dual Energy X-ray Absorptiometry (DXA) at the lumbar vertebrae and femur. Previous studies reported that dental panoramic radiography image has potential information for early osteoporosis detection. This work reported alternative scheme, that consists of the determination of the Region of Interest (ROI) the condyle mandibular in the image as biomarker and feature extraction from ROI and classification of bone conditions. The minimum value of intensity in the cavity area is used to compensate an offset on the ROI. For feature extraction, the fraction of intensity values in the ROI that represent high bone density and the ROI total area is perfomed. The classification will be evaluated from the ability of each feature and its combinations for the BMD detection in 2 classes (normal and abnormal), with the artificial neural network method. The evaluation system used 105 panoramic image data from menopause women which consist of 36 training data and 69 test data that were divided into 2 classes. The 2 classes of classification obtained 88.0% accuracy rate and 88.0% sensitivity rate.

  11. How to improve retromandibular transmasseteric anteroparotid approach for mandibular condylar fractures: our clinical experience.

    Science.gov (United States)

    Salgarelli, A C; Anesi, A; Bellini, P; Pollastri, G; Tanza, D; Barberini, S; Chiarini, L

    2013-04-01

    Fractures of the mandibular condyle are common and account for 25-35% of all mandibular fractures reported in the literature. Even with the development of a consensus on the preference for open reduction and internal fixation of these fractures, the clinician is still faced with a dilemma concerning the optimal approach to the ramus-condyle unit. Limited access and injury to the facial nerve are the most common problems. The most commonly used extraoral approaches are the submandibular, retromandibular and preauricular methods. In this study, we propose a modified cosmetic preauricular incision with a short end in the neck, to improve the transmasseteric anteroparotid (TMAP) approach previously described by Wilson et al. in 2005. We retrospectively analysed 13 patients treated in our department for mandibular condylar fractures. Post-operative complications, occlusal status, interincisal opening and joint tenderness were evaluated at 3 months after surgery. The wider skin incision described here provides a convenient approach for open reduction and rigid internal fixation, and good results were obtained. The follow-up ranged from 6 to 40 months.

  12. Fracture of the occipital condyle caused by minor trauma in child.

    Science.gov (United States)

    Kapapa, Thomas; Tschan, Christoph A; König, Kathrin; Schlesinger, Arkadius; Haubitz, Bernd; Becker, Hartmut; Zumkeller, Matthias; Eckhard, Rickels

    2006-10-01

    We report a case of fractured occipital condyle caused by minor trauma accompanied by light pain on palpation at the lateral cervical trigonum. A 15-year-old boy complained of nuchal pain, particularly pain on palpation at the left lateral cervical trigonum in the absence of neurologic deficits after head deceleration trauma. Computed tomography demonstrated a unilateral nonluxated fracture of the occipital condyle. Owing to consequent immobilization by means of cervical orthosis, pain disappeared after the first 48 hours. Follow-up examination 4 weeks later showed no neurologic deficits. The boy had no severe impairment of movements at the cervical spine.

  13. Custom Made Replacement of the Mandibular Condyle in a Case of Fibrous Dysplasia with Cystic Degeneration; A Case Report

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    Jorinde S. L. I. Oostenbroek-Bisschop

    2016-11-01

    Full Text Available This paper describes a rare case of fibrous dysplasia with cystic degeneration in the mandibular condyle. Diagnostic and therapeutic considerations are discussed. A 40-year old woman presented with pain near the region of her right ear. Physical and radiographic examination showed no abnormalities besides the presence of a mixed radiopaque/radiolucent expansive lesion of the right condyle. Pathologic examination showed high bone-turnover with bone formation. Bone scintigraphy showed a monostotic active fibrous lesion in the right part of the mandible. Bisphosphonate treatment did not sufficiently treat the patient’s symptoms and physiotherapy to treat craniomandibular dysfunction as a factor in the pain was also unsuccessful. The patient later developed an acute external otitis due to a narrowed outer ear canal and had to be admitted to the hospital for treatment with intravenous antibiotics. Approximately two years after first presentation, resection of the affected bone (condylectomy and reconstruction with a custom total joint prosthesis was indicated due to repeated functional deficits with considerable morbidity. Pathologic examination of the resected mandibular condyle showed increased bone formation including formation of neocortex and some cystic formation. This was diagnosed as fibrous dysplasia with cystic degeneration. Approximately two years after surgery, the patient functioned well.

  14. Panoramic radiography: effects of head alignment on the vertical dimension of the mandibular ramus and condyle region.

    Science.gov (United States)

    Sadat-Khonsari, Reza; Fenske, Christian; Behfar, Leyli; Bauss, Oskar

    2012-04-01

    The aim of this study was to assess whether it is possible to derive accurate vertical measurements of the mandibular ramus and condyle from panoramic radiographs. A human dry skull was positioned in a panoramic machine. The skull was displaced along the sagittal and transverse plane and rotated around the vertical and transverse axes. A set of 252 digital radiographs with defined positioning errors was compared with a set of 42 radiographs in the 'ideal' position. The distances between the metal markers that had been attached at the angle of the mandible at a distance of 60 mm in the condyle region to produce fixed reference points on the radiographs were measured. Statistical differences were investigated using Friedman repeated measures analysis of variance on ranks followed by the Dunnett's test for the comparison against the control group in the ideal position (α = 0.05). Vertical measurements were significantly affected when the skull was rotated around the vertical (P vertical measurement of the mandibular ramus and condyle. However, asymmetries of more than 6 per cent are probably not due to patient positioning in the panoramic machine.

  15. Masticatory Function Following Fractures of the Mandibular Condyle

    Science.gov (United States)

    1994-01-10

    DISTRIBUTION CODE Approved for public release; distribution unlimijed 13. ABSTRACT (Maximum 200 words ) Gnathodynamic analyses of function of the...Quantitative analysis of temporomandibularjoint adaptations to protrusive function. Am J Orthod 76:593, 1979. 65. Norman de Burgh JE: Post traumatic...disturbances. Am J Orthod 78:1, 1980. 70. Rahn R, Frank P: Nachuntersuchung von patienten mit kiefergelenkfrakturen mit dem Sirognathographen. ZWR 97:125, 1988

  16. A multi-centre retrospective study of mandibular fractures: do occlusal support and the mandibular third molar affect mandibular angle and condylar fractures?

    Science.gov (United States)

    Hasegawa, T; Sadakane, H; Kobayashi, M; Tachibana, A; Oko, T; Ishida, Y; Fujita, T; Takenono, I; Komatsubara, H; Takeuchi, J; Ichiki, K; Miyai, D; Komori, T

    2016-09-01

    This retrospective study was performed to investigate the influence of occlusal support and the presence, state, and position of mandibular third molars on the incidence of mandibular angle and condylar fractures. The following variables were investigated: age, sex, cause of fracture, presence and state (impaction, angulation, and the number of roots) of the mandibular third molars, site of the mandibular fracture, presence of occlusal support, duration of intermaxillary fixation, and postoperative complications. Various risk factors for mandibular angle and condylar fractures were investigated by univariate analysis. The risk of mandibular angle fracture was significantly higher in patients with occlusal support and mandibular third molars. The risk of condylar fracture was significantly higher in patients without occlusal support or mandibular third molars. The position and angulation of the mandibular third molars were not significant risk factors in mandibular angle and condylar fractures. This study demonstrated the influence of occlusal support and the presence of mandibular third molars on the incidence of mandibular angle and condylar fractures. The presence of occlusal support may be a more important factor affecting mandibular angle or condylar fractures than the position of the mandibular third molars.

  17. Transparotid approach for mandibular condylar neck and subcondylar fractures

    OpenAIRE

    Croce, A; Moretti, A.; Vitullo, F.; CASTRIOTTA, A.; M. Rosa; Citraro, L

    2010-01-01

    SUMMARY Mandibular condylar neck fractures and subcondylar fractures represent, respectively, 19-29% and 62-70% of all mandibular fractures; treatment involves some problems, common to both, concerning the choice of an adequate approach. Herewith, personal experience is reported related to the surgical treatment of some cases of mandibular condylar neck and subcondylar fractures by transparotid approaches with partial parotidectomy, removing the salivary tissue overlying the condylar neck and...

  18. EMG activities of two heads of the human lateral pterygoid muscle in relation to mandibular condyle movement and biting force.

    Science.gov (United States)

    Hiraba, K; Hibino, K; Hiranuma, K; Negoro, T

    2000-04-01

    Electromyographic (EMG) activities of the superior (SUP) and inferior heads (INF) of the lateral pterygoid muscle (LPT) were recorded in humans during voluntary stepwise changes in biting force and jaw position that were adopted to exclude the effects of acceleration and velocity of jaw movements on the muscle activity. The SUP behaved like a jaw-closing muscle and showed characteristic activity in relation to the biting force. It showed a considerable amount of background activity (5-32% of the maximum) even in the intercuspal position without teeth clenching and reached a nearly maximum activity at relatively lower biting-force levels than the jaw-closing muscles during increment of the biting force. Stretch reflexes were found in the SUP, the function of which could be to stabilize the condyle against the biting force that pulls the condyle posteriorly. This notion was verified by examining the biomechanics on the temporomandibular joint. The complex movements of the mandibular condyle in a sagittal plane were decomposed into displacement in the anteroposterior direction (Ac) and angle of rotation (RAc) around a kinesiological specific point on the condyle. In relation to Ac, each head of the LPT showed quite a similar behavior to each other in all types of jaw movements across all subjects. Working ranges of the muscle activities were almost constant (Ac 3 mm for the INF). The amount of EMG activity of the SUP changed in inverse proportion to Ac showing a hyperbola-like relation, whereas that of the INF changed rather linearly. The EMG amplitude of the SUP showed a quasilinear inverse relation with RAc in the hinge movement during which the condyle rotated with no movement in the anteroposterior direction. This finding suggests that the SUP controls the angular relationship between the articular disk and the condyle. On the other hand, the position of the disk in relation to the maxilla, not to the condyle, is controlled indirectly by the INF because the disk

  19. Effect of low-intensity pulsed ultrasound (LIPUS) on mandibular condyle growth in rats analyzed with micro-CT.

    Science.gov (United States)

    Sasaki, Kyozo; Motoyoshi, Mitsuru; Horinuki, Eri; Arai, Yoshinori; Shimizu, Noriyoshi

    2016-01-01

    This study examined the effects of a bite-jumping appliance combined with low-intensity pulsed ultrasound (LIPUS) stimulation on the mandibular condyle of growing rats using micro CT (mCT) and histological examinations. Twelve Wistar rats were divided into three groups of four individuals each: Group 1 was an untreated control group, Group 2 received bite-jumping appliances, and Group 3 received bite-jumping appliances and LIPUS stimulation (15 min/day, 2 weeks) to the temporomandibular region. We measured the length and three-dimensional bone volume of each rat's mandibular condyle using mCT. The condylar cartilage was observed after the rats had been sacrificed. There was no significant difference in condylar sagittal width among the groups. The bite-jumping appliance combined with LIPUS stimulation increased the condylar major axis, mandibular sagittal length and condylar bone volume to a greater degree than use of the bite-jumping appliance alone. Histological examination demonstrated hypertrophy of the condylar cartilage layers, the fibrous layer and hypertrophic cell layer of the rats treated with bite-jumping appliances combined with LIPUS stimulation in comparison to rats treated with bite-jumping appliances alone. (J Oral Sci 58, 415-422, 2016).

  20. Management of neglected lateral condyle fractures of humerus in children: A retrospective study

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    Anil Agarwal

    2012-01-01

    Full Text Available Background: Late presentation of humeral lateral condylar fracture in children is a surgical dilemma. Osteosynthesis of the fracture fragment or correction of elbow deformity with osteotomies and ulnar nerve transposition or sometimes both procedures combined is a controversial topic. We retrospectively evaluated open reduction and fixation cases in late presentation of lateral humeral condyle fracture in pediatric cases with regards to union and functional results. Materials and Methods: Twenty two pediatric (≤12 years patients with fractures of lateral condyle presenting 4 weeks or more post injury between the study period of 2006 and 2010 were included. Multiple K-wires / with or without screws along with bone grafting were used. At final evaluation, union (radiologically and elbow function (Liverpool Elbow Score, LES was assessed. Results: There were 19 boys and 3 girls. Followup averaged 33 months. Pain (n=9, swelling (n=6, restriction of elbow motion (n=6, prominence of lateral condylar region (n=4, valgus deformity (n=4 were the main presenting symptoms. Ulnar nerve function was normal in all patients. There were nine Milch type I and 13 type II fractures. Union occurred in 20 cases. One case had malunion and in another case there was resorption of condyle following postoperative infection and avascular necrosis. Prominent lateral condyles (4/12, fish tail appearance (n=7, premature epiphyseal closure (n=2 were other observations. LES averaged 8.12 (range, 6.66-9.54 at final followup. Conclusions: There is high rate of union and satisfactory elbow function in late presenting lateral condyle fractures in children following osteosynthesis attempt. Our study showed poor correlation between patient′s age, duration of late presentation or Milch type I or II and final elbow function as determined by LES.

  1. Predictors of treatment preference for mandibular fracture.

    Science.gov (United States)

    Der-Martirosian, Claudia; Gironda, Melanie W; Black, Edward E; Belin, Thomas R; Atchison, Kathryn A

    2010-01-01

    Patient treatment preferences do not necessarily remain stable over time. This study focuses on predictors of patient treatment choice and on the extent to which patients are willing to take risks by choosing surgical versus nonsurgical treatment for mandibular fracture. Surveys of African-American and Hispanic adults receiving treatment at King/Drew Medical Center for either a mandibular fracture (n = 98) or third-molar removal (n = 105) were used to investigate patterns of patient preference over the course of a 4-month study period using generalized estimating equations controlling for age, gender, income, and fracture versus third-molar patient. The study examined the effects of symptom rating and a"standard gamble" measure reflecting a patient's willingness to accept scarring or nerve damage. This analysis is based on 169 patients who participated in four waves of data collection. The most salient predictor of patient treatment was the standard gamble measure at 1-month follow-up. Subjects with higher risk tolerance were more likely to select surgery versus jaw wiring. A higher likelihood of choosing surgery was associated with higher income and greater symptom severity. Fracture patients were more likely to select surgery compared with third-molar patients. The significance of symptom severity 1-month post-surgery raises an important issue regarding the healing process. Moreover, the significance of standard gamble as a predictor of treatment choice for mandibular fracture should encourage other researchers to use this measure of willingness to accept risk when studying acute conditions such as jaw fracture.

  2. THE MANAGEMENT OF LIMITED MANDIBULAR MOVEMENT CAUSED BY CONDYLAR FRACTURE WITH REPOSITIONING SPLINT

    Directory of Open Access Journals (Sweden)

    Ira Tanti

    2015-06-01

    Full Text Available Fractures of the neck of condyle usually are the result of a blow to the mandible. A lateral blow to the body of the mandible commonly causes a contralateral condyle fracture. There are many signs and symptoms of a condylar fracture, for example crepitation, deviation of the mandible to the side of injury, and spasm of the associated group of muscles. These will result in a functional disability, which is usually seen as a limited mandibular movement. This paper reported a patient with a fracture of the condylar neck. Patient had been treated with closed reduction and immobilization for 2 months. After that, she felt that her bite was changed, she could not occlude her teeth well, and she had clicking sound in the right joint when she opened her mouth. Besides that, patient had difficulties to move the mandible to the left side, and she could not open her mouth widely. The patient was treated with a repositioning splint and she had to do some jaw exercises. The purposes were to regain the position of condyle, to reduce the muscle spasm and finally got the normal jaw movement.

  3. Two cases of missed Salter-Harris III coronal plane fracture of the lateral femoral condyle.

    Science.gov (United States)

    Sabharwal, Sanjeev; Henry, Patrick; Behrens, Fred

    2008-02-01

    Coronal plane fractures of the lateral femoral condyle can be difficult to diagnose, especially in children with open physis. Two adolescents who sustained this uncommon Salter-Harris III fracture of the knee were misdiagnosed after initial clinical examination and standard x-rays. Oblique x-rays, computed tomography, and magnetic resonance imaging were valuable in arriving at the correct diagnosis and in decision making.

  4. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture

    Energy Technology Data Exchange (ETDEWEB)

    Narvaez, J.A.; Narvaez, J.; Lama, E.De; Sanchez, A. [Department of Magnetic Resonance Imaging, IDI Hospital Duran i Reynals, Ciutat Sanitaria i Universitaria de Bellvitge, Gran Via s/n, 08907, L' Hospitalet de Llobregat (Barcelona) (Spain)

    2003-08-01

    The purpose of this article is to describe the association between spontaneous osteonecrosis and insufficiency stress fractures of the knee. To determine whether insufficiency stress fracture is associated with spontaneous osteonecrosis of the knee, we retrospectively reviewed the medical charts and imaging studies of all patients with spontaneous osteonecrosis of the knee, studied by MR imaging, seen in a tertiary hospital over an 8-year period. Four women (age range 66-84 years) presented spontaneous osteonecrosis of the knee associated with insufficiency stress fracture of the medial tibial plateau. One of these patients also presented a concomitant insufficiency stress fracture of the medial femoral condyle. Radiographs were diagnostic of spontaneous osteonecrosis of the medial femoral condyle in three cases, and insufficiency stress fracture of the medial tibial plateau was detected in one case. Magnetic resonance imaging allows the diagnosis of both conditions in all four cases. Spontaneous osteonecrosis of the knee may be associated with insufficiency stress fracture of the medial femoral condyle and the medial tibial plateau. This association provides additional arguments in favor of the traumatic etiology of spontaneous osteonecrosis of knee. (orig.)

  5. Using conservative condylectomy for management of a large osteochondroma of the mandibular condyle with 6-year follow-up.

    Science.gov (United States)

    Santos, George Soares; Gomes, Julio Bisinotto; de Sousa Maia, Sergio; Bermejo, Patricia Rota; Shinohara, Elio Hitoshi; Sonoda, Celso Koogi; de Melo, Willian Morais

    2014-01-01

    Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure.

  6. Toxic shock syndrome post open reduction and Kirschner wire fixation of a humeral lateral condyle fracture.

    Science.gov (United States)

    Chan, Yuen; Selvaratnam, Veenesh; Garg, Neeraj

    2015-08-11

    Use of Kirschner wires (K-wires) is the most common method of fracture stabilisation in lateral condyle fracture fixation in children. We report a case of toxic shock syndrome (TSS) following an open reduction and internal fixation using K-wires for a humeral lateral condyle fracture in a 5-year-old girl. TSS is a toxin-mediated multisystem illness. It typically presents with shock and it is most often attributed to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. It can lead to multiorgan failure and, ultimately, death. It is important to be aware of TSS, as it can present within any setting. Patients often have non-specific symptoms and their condition can worsen rapidly. TSS postorthopaedic surgery is rare; however, due to the serious nature of this disease, it is important to promptly recognise and diagnose TSS, and to ensure appropriate treatment is started without delay.

  7. Is 3D-CT reformation using free software applicable to diagnosis of bone changes in mandibular condyles?

    Directory of Open Access Journals (Sweden)

    Marília Gerhardt de Oliveira

    2009-06-01

    Full Text Available OBJECTIVES: This study evaluated the agreement of computed tomography (CT imaging using 3D reformations (3DR with shaded surface display (SSD and maximum intensity projection (MIP in the diagnosis of bone changes in mandibular condyles of patients with rheumatoid arthritis (RA, and compared findings with multiplanar reformation (MPR images, used as the criterion standard. MATERIAL AND METHODS: Axial CT images of 44 temporomandibular joints (TMJs of 22 patients with RA were used. Images were recorded in DICOM format and assessed using free software (ImageJ. Each sample had its 3DR-SSD and 3DR-MIP results compared in pairs with the MPR results. RESULTS: Slight agreement (k = 0.0374 was found in almost all comparisons. The level of agreement showed that 3DR-SSD and 3DR-MIP yielded a number of false-negative results that was statistically significant when compared with MPR. CONCLUSIONS: 3DR-SSD or 3DR-MIP should only be used as adjuvant techniques to MPR in the diagnosis of bone changes in mandibular condyles.

  8. Ankylosis of the temporomandibular joint and mandibular growth disturbance caused by neglected condylar fracture in childhood

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    Endrajana Endrajana

    2010-06-01

    Full Text Available Background: Fractures of the mandibular condyle may lead to complications such as disturbance of occlusal function, internal derangement of the joint, ankylosis and mandibular growth disturbance. When treating young patients with the history of mandible trauma, ankylosis of the temporomandibular joint and mandibular growth disturbance are two most important complications of condyle fracture that should be considered. Purpose: This case report attempts to emphasize the long term complication of neglected condylar fracture in children i.e. ankylosis of the temporomandibular joint and subsequently lead to mandibular growth disturbance. Case: A case of right temporo-mandibular joint ankylosis and mandibular growth disturbance in a 28 years old male patient is presented. He had a history of trauma to the mandible after a traffic accident when he was 8 years old. Since then, he experienced difficulty in mouth opening which eventually developed into severe trismus. Case management: The case was treated surgically with gap and interpositional arthroplasty using Mersilen mesh™. Conclusion: Mandibular fractures involving temporomandibular joint in young children should be examined thoroughly and treated adequately in order to prevent ankylosis of the TMJ and the subsequent mandibular growth disturbance.Latar belakang: Fraktur pada kondilus mandibula dapat menyebabkan beberapa komplikasi berupa: gangguan oklusi, internal derangement sendi, ankilosis serta gangguan pertumbuhan mandibula. Pada perawatan penderita usia muda dengan riwayat trauma pada mandibula, perlu diwaspadai dua macam komplikasi akibat fraktur pada kondilus, yaitu ankilosis sendi temporo mandibula dan adanya gangguan pertumbuhan mandibula. Tujuan: Laporan kasus ini bertujuan untuk menekankan bahwa fraktur kondilus pada anak-anak yang tidak mendapatkan perawatan yang semestinya akan mengakibatkan komplikasi jangka panjang berupa ankilosis sendi temporomandibula yang diikuti dengan

  9. Undiagnosed Hoffa fracture of medial femoral condyle presenting as chronic pain in a post-polio limb

    Institute of Scientific and Technical Information of China (English)

    Aditya Krishna Mootha; Priyanka Majety; Vishal Kumar

    2014-01-01

    Isolated coronal fracture of medial femoral condyle with intact lateral femoral condyle is extremely rare.A high index of suspicion is necessary for early diagnosis especially in cases of undisplaced fractures.Here we report a case of medial Hoffa fracture in a post-polio limb presenting as chronic pain.Management of such fractures in limbs affected by late sequelae of poliomyelitis is particularly problematic in view ofosteoporosis and osseous hypoplasia.The fracture was approached through medial parapatellar arthrotomy and fixation was done with cannulated cancellous screws in anteroposterior direction.Union was achieved at 16 weeks.

  10. Mandibular Fractures at Veer Chandra Singh Garhwali Government ...

    African Journals Online (AJOL)

    Mandibular fractures constitute a substantial proportion of cases of maxillofacial ... facial injury that the average practicing dental surgeon may expect to encounter. .... anterior, left and right lateral oblique, panoramic and computed tomography. Simple ... Table 4 shows the relation of fracture site to cause of the mandibular ...

  11. [ANATOMICAL PLATE COMBINED WITH CORTICAL BONE PLATE ALLOGRAFTS FOR TREATMENT OF COMMINUTED FRACTURES OF FEMORAL CONDYLES].

    Science.gov (United States)

    Guo, Zhimin; Gong, Xingxing; Li, Yanwei; Qiu, Xiaochun; Zhang, Meng; Shangguan, Tiancheng; Ao, Qingfang; Liu, Qiang

    2015-01-01

    To summarize the effectiveness of anatomical plate combined with cortical bone plate allografts in the treatment of comminuted fractures of the femoral condyles. Between January 2008 and December 2012, 18 patients with comminuted fractures of the femoral condyles were treated, including 13 males and 5 females with an average age of 45 years (range, 23-65 years). Fractures were caused by traffic accident in 11 cases, by falling from height in 4 cases, and by the other in 3 cases. The locations were the left side in 7 cases and the right side in 11 cases. Of 18 fractures, 12 were open fractures and 6 were closed fractures. The mean time from injury to operation was 6 days (range, 4-15 days). The fixation was performed by anatomical plate combined with cortical bone plate allografts, and autograft bone or allogeneic bone grafting were used. Superficial local skin necrosis occurred in 1 case, and was cured after skin graft, and other incisions achieved primary healing. All patients were followed up 12-36 months (mean, 23 months). X-ray films showed that bone union was achieved within 3-12 months (5.6 months on average). No related complication occurred, such as fixation loosening, refracture, infection, or immunological rejection. According to Merchan et al. criteria for knee joint function evaluation, the results were excellent in 7 cases, good in 9 cases, fair in 1 case, and poor in 1 case at last follow-up; the excellent and good rate was 88.9%. Anatomical plate combined with cortical bone plate allograft fixation is a good method to treat comminuted fractures of the femoral condyles. This method can effectively achieve complete cortical bone on the inside of the femur as well as provide rigid fixation.

  12. Three-dimensional quantitative analysis of the bone density of mandibular condyle in dentulous and edentulous jaws: an in vivo study.

    Science.gov (United States)

    Aggarwal, Himanshi; Singh, Raghuwar D; Kumar, Manoj; Singh, Ragini; Siddhartha, Ramashanker; Jurel, Sunit Kumar; Agrawal, Kaushal K; Kumar, Pradeep

    2015-01-01

    Studies have reported that masticatory function and occlusal force are low in edentulous patients, which brings about a change in the density, thickness, and alignment of bony trabeculae. However, studies that have quantitatively measured the differential cortical and medullary bone densities of the mandibular condyle in vivo remain rare. This study determined and compared the cortical and medullary bone density of the mandibular condyle in dentulous and edentulous jaws, using multidetector computed tomography (CT). Forty mandibular condyles with no clinical signs of temporomandibular disorders were investigated in 2 groups with 10 subjects (aged 50-80 yr) in each group (group I: dentulous subjects with maintained occlusion; group II: completely edentulous patients) with multidetector CT. The density of condylar cortical and medullary bone was determined by using bone density analysis algorithms available within the proprietary software. Data were analyzed statistically with the 1-way analysis of variance test (p<0.05). The mean cortical bone density of the right and left condyles of group I was 686.11±102.78 Hounsfield unit (HU) and 775.91±89.62 HU, respectively and that of group II was 531.33±289.73 HU and 648.53±294.39 HU, respectively. The mean medullary bone density of the right and left condyles was maximum in group I subjects (429.69±102.62 HU and 486.62±108.60 HU, respectively) than in group II subjects (214.89±104.37 HU and 205.36±90.91 HU, respectively) with a statistically significant decrease in the mean scores (p<0.001). Within the limitations of this study, it can be concluded that the cortical and medullary densities of the mandibular condyle are more in dentulous than the edentulous jaws.

  13. Ultrasonography for non-displaced and mini-displaced humeral lateral condyle fractures in children

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jing-dong; CHEN Hua

    2008-01-01

    Objective: To evaluate the value of ultrasonography in non-displaced and mini-displaced humeral lateral condyle fractures in children.Methods: Nine children aged 2-9 years with non-displaced or mini-displaced humeral lateral condyle fractures were examined by high-resolution ultrasonography.The fracture line through the joint surface was visualized by ultrasonography in 6 case,in which closed reduction and percutaneous pinning was performed on 3 patients and other 3 patients did not receive the treatment because of patients' or their parents'refusal.In the remaining 3 children,ultrasonography did not reveal the cartilaginous trochle involvement at the joint surface and conservative treatment was adopted.Results: The average follow-up period was 8 months.The sonographic findings were confirmed by magnetic resonance imaging in one child who received conservative treatment and another child who received percutaneous pinning.The elbow function and fractttre healing were good in cases received closed reduction and percutaneous pinning.Among the three cases who refused to receive closed reduction and internal f'txation,re-displacement occurred in 1 case and delayed union in 1 case.All three cases receiving conservative treatment had good results both in elbow function and fracture healing.Conclusion: High-resolution ultrasonography enable to reveal non-displaced and mini-displaced humeral lateral condyle fractures as well as to ascertain whether the cartilaginous trochlea humeri was involved.For these cases,arthrography or magnetic resonance imaging is unnecessary.

  14. 可吸收螺钉双皮质骨固定羊髁突矢状骨折的实验研究%Experimental study on surgical treatment of sagittal fractures of mandibular condyle with biocortical resorbable pins in sheep

    Institute of Scientific and Technical Information of China (English)

    孟凡文; 刘美霞; 王家伟; 王丽; 吴晓亮

    2015-01-01

    目的:通过髁突矢状骨折(sagittal fractures of mandibular condyle,SFMC)动物模型,检验侧向可吸收螺钉手术治疗SFMC的效果,以及利用该螺钉稳定固位和不稳定固位的区别.方法:16只成年绵羊,制备成右侧SFMC动物模型,随机分为4组,每组4只.对照组采用保守治疗,实验1组采用侧向钛螺钉双皮质骨固定技术予以治疗,实验2组采用侧向可吸收螺钉以拉力螺钉的方式行切开复位内固定手术(open reduction and internal fixation,ORIF)治疗(不稳定固定),实验3组采用侧向可吸收螺钉以双皮质固定方式行ORIF治疗(稳定固定),分别在截骨术后、骨折内固定术后即刻、保守治疗或骨折内固定治疗3个月后行颞下颌关节(temporamadibular joint,TMJ)计算机断层扫描(computed tomography,CT),对TMJ的形态改变进行放射学评分.治疗3个月后处死动物,解剖、观察、测量TMJ形态变化及组织学改变.采用SPSS 18.0软件包中的配对t检验和两样本t检验对结果进行统计学分析.结果:对照组、实验2组动物实验侧TMJ CT影像及髁突的前后径和内外径明显异常,关节盘与髁突黏连,质地变脆,部分区域关节盘破损,关节窝有不同程度虫蚀状骨质破坏.实验1组和3组实验侧TMJ基本正常,反映TMJ形态改变的放射学评分2.60±0.94(实验1组)和2.90±1.06(实验3组)显著低于对照组(11.40±1.98)和实验2组(10.20±2.18).组织学检查提示,对照组、实验2组动物实验侧关节盘出现纤维软骨黏液变性,髁突和关节窝表面软骨也出现黏液样变性,髁突骨质不规则增生,实验1组和3组实验侧关节盘、髁突和关节窝表面软骨未见明显改变.结论:髁突矢状骨折后精确复位和稳定固定,是TMJ恢复正常解剖形态的前提,只要操作得当,可吸收螺钉与钛螺钉一样,均可获得稳定的固位和良好的治疗效果,由于不需二次手术取出,可吸收螺钉作为SFMC内固定材料,具

  15. CAD-CAM-generated hydroxyapatite scaffold to replace the mandibular condyle in sheep: preliminary results.

    Science.gov (United States)

    Ciocca, Leonardo; Donati, Davide; Fantini, Massimiliano; Landi, Elena; Piattelli, Adriano; Iezzi, Giovanna; Tampieri, Anna; Spadari, Alessandro; Romagnoli, Noemi; Scotti, Roberto

    2013-08-01

    In this study, rapid CAD-CAM prototyping of pure hydroxyapatite to replace temporomandibular joint condyles was tested in sheep. Three adult animals were implanted with CAD-CAM-designed porous hydroxyapatite scaffolds as condyle substitutes. The desired scaffold shape was achieved by subtractive automated milling machining (block reduction). Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Using the same technique, fixation plates were created and applied to the scaffold pre-operatively to firmly secure the condyles to the bone and to assure primary stability of the hydroxyapatite scaffolds during masticatory function. Four months post-surgery, the sheep were sacrificed. The hydroxyapatite scaffolds were explanted, and histological specimens were prepared. Different histological tissues penetrating the scaffold macropores, the sequence of bone remodeling, new apposition of bone and/or cartilage as a consequence of the different functional anatomic role, and osseointegration at the interface between the scaffold and bone were documented. This animal model was found to be appropriate for testing CAD-CAM customization and the biomechanical properties of porous, pure hydroxyapatite scaffolds used as joint prostheses.

  16. Intermaxillary Fixation Screw Morbidity in Treatment of Mandibular Fractures

    DEFF Research Database (Denmark)

    Florescu, Vlad-Andrei; Kofod, Thomas; Pinholt, Else Marie

    2016-01-01

    Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark). The fracture type, radiographic findings, treatment modality, screw type and number, and root damage were recorded. For the outcome comparison, a review of the published data regarding iatrogenic dental root damage caused......Purpose The aim of the present retrospective study was to investigate the morbidity of screws used for intermaxillary fixation (IMF) in the treatment of mandibular fractures. A review of the published data was also performed for a comparison of outcomes. Our hypothesis was that the use of screws...... for IMF of mandibular fractures would result in minimal morbidity. Materials and Methods Patients treated for mandibular fractures from 2007 to 2013, using screws for IMF, using the international diagnosis code for mandibular fracture, DS026, were anonymously selected (Department of Oral and Maxillofacial...

  17. Malunited fracture of the body and condyle of the mandible : A Case Report

    Directory of Open Access Journals (Sweden)

    Ramakrishna Yeluri

    2010-01-01

    Full Text Available Mandibular fractures are the most common facial fractures seen in hospitalized children and their incidence increases with age. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. Many factors complicate the management of pediatric mixed-dentition mandibular fractures: tooth eruption, short roots, developing tooth buds and growth issues. One major factor is the inherent instability of the occlusion in the mixed deciduous-permanent tooth phase. This case report documents a child in mixed dentition period with a complication arising due to direct fixation of the fractured mandible.

  18. Lateral Condyle Fracture of the Humerus in Children Treated with Bioabsorbable Materials

    Directory of Open Access Journals (Sweden)

    Véronique Andrey

    2013-01-01

    Full Text Available The aim of this study was to compare clinical and radiological outcome of lateral condyle fracture of the elbow in children treated with bioabsorbable or metallic material. From January 2008 to December 2009, 16 children with similar fractures and ages were grouped according to the fixation material used. Children were seen at 3, 6, and 12 months and more than 4 years (mean 51.8 months postoperatively. The clinical results were compared using the Mayo Elbow Performance Score (MEPS. Radiographic studies of the fractured and opposite elbow were assessed at last follow-up control. Twelve children had a sufficient followup and could be included in the study. Seven could be included in the traditional group and 5 in the bioabsorbable group. At 12 months, the MEPS was 100 for every child in both groups. Asymptomatic bony radiolucent visible tracks and heterotopic ossifications were noted in both groups. There were no significant differences in terms of clinical and radiological outcome between the two groups. The use of bioabsorbable pins or screws is a reasonable alternative to the traditional use of metallic materials for the treatment of lateral condyle fracture of the elbow in children.

  19. MRI of the temporo-mandibular joint: which sequence is best suited to assess the cortical bone of the mandibular condyle? A cadaveric study using micro-CT as the standard of reference

    Energy Technology Data Exchange (ETDEWEB)

    Karlo, Christoph A. [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Patcas, Raphael; Signorelli, Luca; Mueller, Lukas [University of Zurich, Clinic for Orthodontics and Pediatric Dentistry, Center of Dental Medicine, Zurich (Switzerland); Kau, Thomas; Watzal, Helmut; Kellenberger, Christian J. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Ullrich, Oliver [University of Zurich, Institute of Anatomy, Faculty of Medicine, Zurich (Switzerland); Luder, Hans-Ulrich [University of Zurich, Section of Orofacial Structures and Development, Center of Dental Medicine, Zurich (Switzerland)

    2012-07-15

    To determine the best suited sagittal MRI sequence out of a standard temporo-mandibular joint (TMJ) imaging protocol for the assessment of the cortical bone of the mandibular condyles of cadaveric specimens using micro-CT as the standard of reference. Sixteen TMJs in 8 human cadaveric heads (mean age, 81 years) were examined by MRI. Upon all sagittal sequences, two observers measured the cortical bone thickness (CBT) of the anterior, superior and posterior portions of the mandibular condyles (i.e. objective analysis), and assessed for the presence of cortical bone thinning, erosions or surface irregularities as well as subcortical bone cysts and anterior osteophytes (i.e. subjective analysis). Micro-CT of the condyles was performed to serve as the standard of reference for statistical analysis. Inter-observer agreements for objective (r = 0.83-0.99, P < 0.01) and subjective ({kappa} = 0.67-0.88) analyses were very good. Mean CBT measurements were most accurate, and cortical bone thinning, erosions, surface irregularities and subcortical bone cysts were best depicted on the 3D fast spoiled gradient echo recalled sequence (3D FSPGR). The most reliable MRI sequence to assess the cortical bone of the mandibular condyles on sagittal imaging planes is the 3D FSPGR sequence. (orig.)

  20. Update on patterns of mandibular fracture in Tasmania, Australia.

    Science.gov (United States)

    Verma, Shreya; Chambers, Ian

    2015-01-01

    Mandibular fractures often present to hospital, so if we understand trends in patterns of fractures and their demographics it may help us to deliver a better service, and prevent these injuries. Here, we compare current data on mandibular fractures in Tasmania with data from 15 years ago, and with current world trends. Patients who presented to the Royal Hobart Hospital with fractured mandibles were audited, and the data analysed and compared with those from a previous study. About 37 fractured mandibles presented to hospital each year. Most patients were men aged 20-30 years old. Ninety-seven of the 159 fractures (61%) were secondary to assault, 27 (17%) were the result of sport, and 24 (15%) followed falls. Road crashes contributed only 5% of mandibular fractures. Sixty-six patients (60%) were intoxicated at the time of injury. The angle of the mandible was the most common site of fracture and open reduction and internal fixation was the treatment of choice. There have been important changes in mandibular fracture patterns in Tasmania in the last 15 years. There was a rise in alcohol-related interpersonal violence, and men were most commonly involved. There was also a decrease in mandibular fractures caused by road crashes, which suggests an improvement in road safety.

  1. Bilateral Mandibular Condylar Fractures with Associated External Auditory Canal Fractures and Otorrhagia

    OpenAIRE

    Dang, David

    2016-01-01

    A rare case of bilateral mandibular condylar fractures associated with bilateral external auditory canal fractures and otorrhagia is reported. The more severe external auditory canal fracture was present on the side of high condylar fracture, and the less severe external auditory canal fracture was ipsilateral to the condylar neck fracture. A mechanism of injury is proposed to account for such findings.

  2. Bilateral Mandibular Condylar Fractures with Associated External Auditory Canal Fractures and Otorrhagia.

    Science.gov (United States)

    Dang, David

    2007-01-01

    A rare case of bilateral mandibular condylar fractures associated with bilateral external auditory canal fractures and otorrhagia is reported. The more severe external auditory canal fracture was present on the side of high condylar fracture, and the less severe external auditory canal fracture was ipsilateral to the condylar neck fracture. A mechanism of injury is proposed to account for such findings.

  3. Fraturas do côndilo mandibular: classificação e tratamento Mandibular condylar fractures: classification and treatment

    Directory of Open Access Journals (Sweden)

    Luiz C. Manganello

    2002-10-01

    Full Text Available As fraturas do côndilo mandibular, dentre as fraturas faciais, são as que apresentam o maior número de controvérsias quanto ao seu tratamento e maior dificuldade de diagnóstico. A escolha de um tratamento - cirúrgico, bloqueio maxilo-mandibular, fisioterapia elástica ou associação -, está diretamente ligado ao tipo de fratura, à idade do paciente e ao grau de alteração funcional em decorrência da fratura. Os exames por imagens são importantes para o diagnóstico e classificação da fratura, no entanto, os achados clínicos são mais relevantes na indicação de um tratamento cirúrgico ou conservador. Este trabalho tem como objetivo apresentar uma classificação das fraturas do côndilo relacionada com o seu tratamento e relatar dois casos clínicos, sendo um tratado de forma cirúrgica e o outro conservadoramente, discutindo as vantagens e desvantagens do tratamento cirúrgico, bem como as indicações e contra-indicações.Condylar fractures are considered one of the most controversial fractures in face regarding treatment and diagnostic difficulty. Choosing the best treatment, such as surgery, inter maxillary fixation, physiotherapy or their association is directly related to fractures type, patient age and functional impairment degree. Clinical findings are relevant for proper diagnostic but image is fundamental for a precise treatment indication. We present a novel classification based on the condyle deviation and also propose a treatment for each type of fracture regarding age and clinical symptoms. We illustrate this paper with a description of two cases, one submitted to surgical and other to clinical treatment.

  4. Mandibular Ramus Fracture: An Overview of Rare Anatomical Subsite

    Directory of Open Access Journals (Sweden)

    Anendd Jadhav

    2015-01-01

    Full Text Available Aim. The present study aims at exemplifying the incidence, and aetiology and analyses the outcomes of open reduction internal fixation (ORIF over closed treatment of mandibular ramus fractures. Patients and Method. In the present retrospective analysis of mandibular fracture patients, variables analysed were age, sex, cause of injury, pretreatment occlusion, treatment given, period of maxillo-mandibular fixation (MMF, and posttreatment occlusion. Results. Out of 388 mandibular fractures treated, ramus fractures were 12 (3.09%. In the present study, predominant cause of mandibular ramus fracture was road traffic accident (RTA n = 07 (58.33% followed by fall n = 04 (33.33% and assault n = 1 (8.33%. The average age was 35.9 years with a male predilection. Of these, 9 patients were treated with ORIF while remaining 3 with closed treatment. The average MMF after closed treatment was 21 days and 3 to 5 days after ORIF. There was improvement in occlusion in all 12 patients posttreatment with no major complication except for reduced mouth opening in cases treated with ORIF which recovered with physiotherapy and muscle relaxants. Conclusion. Mandibular ramus fractures accounted for 3.09% with RTA as a common aetiology. ORIF of ramus fractures facilitated adequate functional and anatomic reduction with early return of function.

  5. Late presentation of fractures of the lateral condyle of the humerus in children

    Directory of Open Access Journals (Sweden)

    Khare Ghanshyam

    2011-01-01

    Full Text Available Background: The current controversy regarding the management of fractures of the lateral condyle of the humerus presenting between 3 to 12 weeks prompted us to evaluate our results of open reduction and internal fixation of such fractures. Patients and Methods: Twenty-one patients operated between March 1995 and February 2001 qualified for this study. Five patients presented between 3-4 weeks, nine between 5-8 weeks and seven between 9-12 weeks post injury. Ten fractures were classified as stage II and eleven as stage III (Jacob et al. criteria. The mean age was 8 years (range: 4-14 years. All patients underwent surgery (open reduction and internal fixation with K-wires/screw, with or without bone grafting. The results were assessed by the modified criteria of Agarwal et al. after an average follow-up of 2.3 years. Results: Excellent to good results were observed in all the five patients presenting at 3-4 weeks post injury. In the patients presenting at 5-8 weeks, the results were excellent in one, good in four, fair in three, and poor in one patient. The fracture united in all cases; however, malunion was observed in four patients. The fractures that were operated at 9-12 weeks showed good results in one case, fair result in three cases, and poor result in three cases. Avascular necrosis of the lateral condyle in one patient, premature fusion in two patients, pin tract infection in three patients, and gross restriction of elbow movements in three patients were the major complications in this group. Accurate reduction was difficult as a result of new bone formation and remodeling at the fracture surfaces. Multiple incisions over the common extensor aponeurosis and bone graft supplementation were helpful for achieving acceptable reduction. Conclusion: Open reduction and internal fixation is recommended in all cases of displaced fractures of the lateral condyle of the humerus presenting at up to 12 weeks post injury. However, the results become

  6. A case report of aneurysmal bone cyst of the mandibular condyle

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Jae Ho; Lee, Sam Sun; Choi, Soon Chul; Park, Tae Won; You, Dong Soo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1997-02-15

    The aneurysmal bone cyst is a nonmalignant reactive bone lesion. Developing rarely in the craniofacial region, and more commonly affecting the long bones and the spine, the lesion has variable etiopathogenic characteristics. The author s diagnosed a 33-year-old female as aneurysmal bone cyst after undergoing clinical, radiological and histological examinations. The characteristics were as followed : 1. The patient complained of pain and swelling of the right preauricular area. 2. The conventional radiograms showed a relatively well defined radiolucent lesion with partially scalloping margin. The cortical bone of the right condyle was thinned and expanded by the lesion. 3. Bone scintigraphy with {sup 99m}Tc demonstrated ring-like or doughnut-pattern accumulation of radioactivity. 4. On T1-weighted imaging of MRI, the lesion on the right condyle had middle signal intensity. T2-weighted MRI demonstrated multiple high signal intensities separated by septa which had low signal intensity. Finger in balloon appearance wa s seen. 5. Histologically, the lesion was composed of large sinusoidal blood spaces lined by fibroblasts and histiocytes. Its fibrous stroma consisted of fibroblastic element, multinucleated giant cells, extravasated erythrocytes and focal hemosiderin pigmentation. New bone formation was also observed around larger sinusoidal spaces.

  7. Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey

    Directory of Open Access Journals (Sweden)

    Serhat Atilgan

    2010-02-01

    Full Text Available OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70% males and 162 (30% females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65% in young patients and traffic accidents (38% in adults. The most common fracture sites were the symphysis (35% and condyle (36% in young patients, and the symphysis in adults (36%. Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67% and adult (39% patients, and 43% of the adult patients were treated by open reduction and internal fixation. CONCLUSION: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

  8. Prognosis of teeth involved in the line of mandibular fractures.

    Science.gov (United States)

    Kahnberg, K E; Ridell, A

    1979-06-01

    The management of teeth positioned in the line of mandibular jaw fractures was studied by a follow-up examination of 132 patients with mandibular fractures involving 185 teeth. The observation period varied from 1 to 3 years. The clinical and radiographic findings revealed complete recovery in 59% of the involved teeth. The degree of periodontal and pulpal complications were closely related to the displacement between the fragments and to the type of fracture. Six different fracture types were classified with regard to the extent of involvement of the tooth supporting tissue; 23% of the teeth which initially responded negatively to electric stimulation showed positive sensibility at the time of reexamination. Thus, a long time observation period is advisable with regard to the final outcome of the pulp damage. Conservative treatment of teeth involved in the line of mandibular fractures has a favorable prognosis especially if optimal reduction of the jaw fragments is achieved.

  9. Fractures of the mandibular coronoid process: a two centres study.

    Science.gov (United States)

    Boffano, Paolo; Kommers, Sofie C; Roccia, Fabio; Gallesio, Cesare; Forouzanfar, Tymour

    2014-10-01

    The aim of this study was to assess the characteristics of patients with coronoid fractures treated in two European centres over 10 years and to briefly review the literature. This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures and surgically treated in two European centres between 2001 and 2010. During the 10 years, 1818 patients and 523 patients with maxillofacial fractures were admitted to the two centres respectively: 21 patients (16 males, 5 females) were admitted with 21 coronoid fractures and 28 associated maxillofacial fractures. A mean age of 42.1 years was observed. The fractures were mainly the result of motor vehicle accidents, followed by assaults and falls. The most frequently observed associated maxillofacial fracture was a zygomatic fracture (13 fractures). In both centres, mandibular coronoid fractures are treated unless a severe dislocation of the fractured coronoid is observed or a functional mandibular impairment is encountered. Conservative treatment can be used, together with the open reduction and internal fixation of associated fractures. The crucial point is to prevent ankylosis, which may be prevented by correct and early postoperative physiotherapy and mandibular function.

  10. Age-related changes in collagen properties and mineralization in cancellous and cortical bone in the porcine mandibular condyle.

    Science.gov (United States)

    Willems, Nop M B K; Langenbach, Geerling E J; Everts, Vincent; Mulder, Lars; Grünheid, Thorsten; Bank, Ruud A; Zentner, Andrej; van Eijden, Theo M G J

    2010-04-01

    Collagen is an important constituent of bone, and it has been suggested that changes in collagen and mineral properties of bone are interrelated during growth. The aim of this study was to quantify age-related changes in collagen properties and the degree of mineralization of bone (DMB). The DMB in cancellous and cortical bone samples from the mandibular condyle of 35 female pigs aged 0-100 weeks was determined using micro-computed tomography. Subsequently, the amount of collagen and the number of pentosidine (Pen), hydroxylysylpyridinoline (HP), and lysylpyridinoline (LP) cross-links were quantified by means of high-performance liquid chromatography. The amount of collagen increased with age in cancellous bone but remained unchanged in cortical bone. The number of Pen and LP cross-links decreased in both bone types. In contrast, the number of HP cross-links decreased only in cancellous bone. The sum of the number of HP and LP cross-links decreased with age in cancellous bone only. The DMB increased in cancellous and cortical bone. It was concluded that the largest changes in the number of mature collagen cross-links and the mineralization in porcine cancellous and cortical bone take place before the age of 40 weeks. The low number of mature cross-links after this age suggests that the bone turnover rate continues to be high and thereby prevents the development of mature cross-links.

  11. An Epidemiological Study on Pattern and Incidence of Mandibular Fractures

    Directory of Open Access Journals (Sweden)

    Subodh S. Natu

    2012-01-01

    Full Text Available Mandible is the second most common facial fracture. There has been a significant increase in the number of cases in recent years with the advent of fast moving automobiles. Mandibular fractures constitute a substantial proportion of maxillofacial trauma cases in Lucknow. This study was undertaken to study mandibular fractures clinicoradiologically with an aim to calculate incidence and study pattern and the commonest site of fractures in population in and around Lucknow. Patient presenting with history of trauma at various centers of maxillofacial surgery in and around Lucknow were included in this study. Detailed case history was recorded followed by thorough clinical examination, and radiological interpretation was done for establishing the diagnosis and the data obtained was analyzed statistically. Out of 66 patients with mandibular fractures, highest percentage was found in 21–30 years of age with male predominance. Road traffic accidents were the most common cause of fracture with parasymphysis being commonest site. Commonest combination was parasymphysis with subcondyle. There was no gender bias in etiology with number of fracture sites. 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.

  12. Morphological and cellular examinations of experimentally induced malocclusion in mice mandibular condyle.

    Science.gov (United States)

    Jung, Jae-Kwang; Sohn, Wern-Joo; Lee, Youngkyun; Bae, Yong Chul; Choi, Jae-Kap; Kim, Jae-Young

    2014-02-01

    Occlusal alignment is known clinically to have a widespread influence on the stomatognathic system, including the temporomandibular joint and masticatory muscles. However, while occlusion is still an important determinant of most dental treatments, the exact effect of occlusal alignment is unclear because of a lack of conclusive scientific evidence. In this study, a malocclusion model system is used to examine the cellular and histologic alterations in the contralateral condyle of mice after a malocclusion was induced by a build-up of resin on the left maxillary molars. A significant decrease in the thickness of the condylar cartilage was found in the 1-week experimental group, together with increased apoptosis and decreased proliferation in the condylar head, which included cartilage and subchondral bone. Additionally, the number of TRAP-positive osteoclasts and MPO- and F4/80-positive inflammatory cells in the subchondral bone were significantly higher in the 1-week experimental group. Unbalanced malocclusion caused increased bone remodeling, as evidenced by increased osteoclastic activity and inflammatory responses (macrophages and neutrophils, respectively). However, these alterations in the 1-week experimental group were subsequently attenuated and restored almost to the baseline at 3 weeks after the induction of the malocclusion.

  13. Accuracy of radiographs in assessment of displacement in lateral humeral condyle fractures.

    Science.gov (United States)

    Knutsen, Ashleen; Avoian, Tigran; Borkowski, Sean L; Ebramzadeh, Edward; Zionts, Lewis E; Sangiorgio, Sophia N

    2014-02-01

    Determining the magnitude of displacement in pediatric lateral humeral condyle fractures can be difficult. The purpose of this study was to (1) assess the effect of forearm rotation on true fracture displacement using a cadaver model and to (2) determine the accuracy of radiographic measurements of the fracture gap. A non-displaced fracture was created in three human cadaveric arms. The specimens were mounted on a custom apparatus allowing forearm rotation with the humerus fixed. First, the effect of pure rotation on fracture displacement was simulated by rotating the forearm from supination to pronation about the central axis of the forearm, to isolate the effects of muscle pull. Then, the clinical condition of obtaining a lateral oblique radiograph was simulated by rotating the forearm about the medial aspect of the forearm. Fracture displacements were measured using a motion-capture system (true-displacement) and clinical radiographs (apparent-displacement). During pure rotation of the forearm, there were no significant differences in fracture displacement between supination and pronation, with changes in displacement of <1.0 mm. During rotation about the medial aspect of the forearm, there was a significant difference in true displacements between supination and pronation at the posterior edge (p < 0.05). Overall, true fracture displacement measurements were larger than apparent radiographic displacement measurements, with differences from 1.6 to 6.0 mm, suggesting that the current clinical methods may not be sensitive enough to detect a displacement of 2.0 mm, especially when positioning the upper extremity for an internal oblique lateral radiograph.

  14. Factors contributing to the surgical retreatment of mandibular fractures

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    João Gualberto de Cerqueira Luz

    2013-06-01

    Full Text Available The purpose of this retrospective study was to evaluate contributing factors in patients requiring surgical retreatment of mandibular fractures. Of all the patients with mandibular fractures who were treated using internal fixation at a trauma hospital over a seven-year period, 20 patients (4.7% required a second surgery and thus composed the “reoperated” group. The control group comprised 42 consecutive patients with mandibular fractures who were treated at the same clinic and who healed without complications. Medical charts were reviewed for gender, age, substance abuse history, dental condition, etiology, location of fracture, degree of fragmentation, fracture exposure, teeth in the fracture line, associated facial fractures, polytrauma, time elapsed between trauma and initial treatment, surgical approach and fixation system. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS version 20.0; descriptive statistics and the chi-squared test were used to determine differences between groups. Significant differences in substance abuse (p = 0.006, dental condition (p < 0.001, location of fracture (p = 0.010, degree of fragmentation (p = 0.003 and fracture exposure (p < 0.001 were found. With regard to age and time elapsed between trauma and initial treatment, older patients (31.4 years, SD = 11.1 and a delay in fracture repair (19.1 days, SD = 18.7 were more likely to be associated with reoperation. It was concluded that substance abuse, age, dental condition, location of fracture, degree of fragmentation, fracture exposure and the time between trauma and initial treatment should be considered contributing factors to the occurrence of complications that require surgical retreatment of mandibular fractures.

  15. Relationship between mandibular angle fracture and state of eruption of mandibular third molar: A digital radiographic study

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    Mahesh Kumar Talkad Subbaiah

    2015-01-01

    Full Text Available Objectives: The purpose of this study was to assess the relationship between mandibular angle fracture and the status of eruption of the mandibular third molars. Materials and Methods: The sample consisted of 50 mandibular angle fracture cases with or without the presence of mandibular third molars, inclusive of both genders in the age group 18 years and above. The mandibular angle fractures were assessed by taking an orthopantomograph for each case following strict radiation protection protocol after an informed consent was obtained. The captured image was assessed and traced for the presence of mandibular angle fracture, angulation, and status of mandibular third molar by using Windows Trophy DICOM and Master View 3.0 software. Pell and Gregory′s and Winter′s classifications were followed. Results: We observed the following: Increased incidence of angle fractures in the presence of mandibular third molar, male predominance, the mean average age being 29 years, and the most common cause of angle fractures was road traffic accident; the fractures were observed more on the left side. In the total sample, mandibular third molar was present in 90% of the cases with angle fracture; of this, 73% of the teeth were impacted. Increased incidence of mandibular angle fracture was observed in position A, class II, and mesioangular impaction of third molar, which were statistically significant. Conclusion: The presence of mandibular third molar was in strong association with mandibular angle fracture and there was an increased incidence of position A, class II, and mesioangular impaction, when compared with other positions. This study concludes that there is a direct relationship between the presence and status of impacted third molars with increased risk of mandibular angle fracture.

  16. Incidencia de fracturas mandibulares en Guyana INCIDENCE OF MANDIBULAR FRACTURES IN GUYANA

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    Luis Hernández Pedroso

    2005-04-01

    Full Text Available Se realiza un estudio retrospectivo de la incidencia de las fracturas mandibulares en relación con el total de las fracturas maxilofaciales atendidas en la República de Guyana durante el año 2001 debido a su alta presentación en nuestro quehacer diario, con el objetivo de determinar el comportamiento de estas lesiones y su relación con la edad, sexo, etiología y área mandibular vulnerable. Las variables estudiadas fueron sexo, edad, causa de la fractura y región afectada. Las fracturas mandibulares ocuparon el 56,6 % del total de fracturas maxilofaciales y fue más frecuente en los hombres ( 89,5 %. Los grupos etáreos de mayor incidencia fueron de 25 a 34 y de 35 a 44 años, con el 30,6 %. La causa más común de fracturas mandibulares fue la agresión personal ( 68,6 % y la región anatómica más afectada el ángulo mandibular ( 67,4 %.A retrospective study of the incidence of mandibular fractures in relation to the total of maxillofacial fractures attended in the Republic of Guyana during 2001 was conducted taking into account its high ocurrence in our daily practice in order to determine the behavior of these injuries and its connection with age, sex, etiology and vulnerable mandibular area. The variables studied were sex, age, cause of the fracture and affected region. The mandibular fractures accounted for 56.6 % of the total of maxillofacial fractures and they were more frequent in men (89.5 %. The age groups with the highest incidence were from 25 to 34 and from 35 to 44 years old, accounting for 30.6 %. The most frequent cause of mandibular fracture was personal aggression (68.6 % and the commonest anatomical region was the mandibular angle (67.4 %.

  17. Femoral condyle insufficiency fractures: associated clinical and morphological findings and impact on outcome

    Energy Technology Data Exchange (ETDEWEB)

    Plett, Sara K.; Hackney, Lauren A.; Heilmeier, Ursula; Nardo, Lorenzo; Zhang, Chiyuan A.; Link, Thomas M. [Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (United States); Yu, Aihong [Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (United States); 4th Medical College of Peking University, Department of Radiology, Beijing Jishuitan Hospital, Beijing (China)

    2015-12-15

    To determine the characteristics of femoral condyle insufficiency fracture (FCIF) lesions and their relative associations with the risk of clinical progression. This HIPAA-compliant retrospective study was approved by our Institutional Review Board. Seventy-three patients (age range, 19-95) were included after excluding patients with post-traumatic fractures, bone marrow infarct, osteochondritis dissecans, or underlying tumor. Two board-certified musculoskeletal radiologists classified morphologic findings including lesion diameter, associated bone marrow edema pattern, and associated cartilage/meniscus damage. Electronic medical charts were evaluated for symptoms, risk factors, and longitudinal outcomes, including total knee arthroplasty (TKA). Imaging characteristics were correlated with clinical findings, and comparison of outcome groups was performed using a regression model adjusted for age. The majority of patients with FCIF were women (64.4 %, 47/73), on average 10 years older than men (66.28 ± 15.86 years vs. 56.54 ± 10.39 years, p = 0.005). The most common location for FCIF was the central weight-bearing surface of the medial femoral condyle; overlying full thickness cartilage loss (75.7 %, 53/70) and ipsilateral meniscal injury (94.1 %, 64/68) were frequently associated. Clinical outcomes were variable, with 23.9 % (11/46) requiring TKA. Cartilage WORMS score, adjacent cartilage loss, and contralateral meniscal injury, in addition to decreased knee range of motion at presentation, were significantly associated with progression to TKA (p < 0.05). FCIF are frequently associated with overlying cartilage loss and ipsilateral meniscal injury. The extent of cartilage loss and meniscal damage, in addition to loss of knee range of motion at the time of presentation, are significantly associated with clinical progression. (orig.)

  18. Inferior alveolar nerve injuries associated with mandibular fractures.

    Science.gov (United States)

    Bede, Salwan Yousif Hanna; Ismael, Waleed Khaleel; Al-Assaf, Dhuha A; Omer, Saad Salem

    2012-11-01

    The study evaluates the incidence of inferior alveolar nerve injuries in mandibular fractures, the duration of their recovery, and the factors associated with them. Fifty-two patients with mandibular fractures involving the ramus, angle, and body regions were included in this study; the inferior alveolar nerve was examined for neurological deficit posttraumatically using sharp/blunt differentiation method, and during the follow-up period the progression of neural recovery was assessed. The incidence of neural injury of the inferior alveolar nerve was 42.3%, comminuted and displaced linear fractures were associated with higher incidence of inferior alveolar nerve injury and prolonged recovery time, and recovery of inferior alveolar nerve function occurred in 91%.Fractures of the mandible involving the ramus, angle, and body regions, and comminuted and displaced linear fractures are factors that increase the incidence of inferior alveolar nerve injuries. Missile injuries can be considered as another risk factor.

  19. The effect of local injection of the human growth hormone on the mandibular condyle growth in rabbit

    Directory of Open Access Journals (Sweden)

    Masood Feizbakhsh

    2014-01-01

    Full Text Available Background: The aim of this study was to evaluate the effect of local injection of human growth hormone (GH in stimulating cartilage and bone formation in a rabbit model of temporomandibular joint (TMJ. Materials and Methods: In an experimental animal study, 16 male Albino New Zealand white rabbits aged 12 weeks were divided into two groups: In the first group (7 rabbits 2 mg/kg/1 ml human GH and in the control group (9 rabbits 1 ml normal saline was administered locally in both mandibular condyles. Injections were employed under sedation and by single experienced person. Injections were made for 6 times with 3 injections a week in the all test and control samples. Rabbits were sacrified at the 20th day from the beginning of study and TMJs were histologically examined. ANOVA (two-sided with Dunnett post hoc test was used to compare data of bone and cartridge thickness while chi-square test was used to analyze hyperplasia and disk deformity data. P < 0.05 was considered as significant. Results: Cartilage layer thickness was greater in the GH-treated (0.413 ± 0.132 than the control group (0.287 ± 0.098 (P value = 0.02. Although bone thickness and condylar cartilage hyperplasia were greater in the GH-treated group, these differences were not statistically significant (P value = 0.189 and 0.083, respectively. There was no statistically significant difference between two groups regarding the disc deformity (P value = 0.46. Conclusion: Local injection of human GH in the TMJ is able to accelerate growth activity of condylar cartilage in rabbit.

  20. Determination of the relationship between collagen cross-links and the bone-tissue stiffness in the porcine mandibular condyle.

    Science.gov (United States)

    Willems, Nop M B K; Mulder, Lars; Bank, Ruud A; Grünheid, Thorsten; den Toonder, Jaap M J; Zentner, Andrej; Langenbach, Geerling E J

    2011-04-07

    Although bone-tissue stiffness is closely related to the degree to which bone has been mineralized, other determinants are yet to be identified. We, therefore, examined the extent to which the mineralization degree, collagen, and its cross-links are related to bone-tissue stiffness. A total of 50 cancellous and cortical bone samples were derived from the right mandibular condyles of five young and five adult female pigs. The degree of mineralization of bone (DMB) was assessed using micro-computed tomography. Using high-performance liquid chromatography, we quantified the collagen content and the number of cross-links per collagen molecule of two enzymatic cross-links: hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP), and one non-enzymatic cross-link: pentosidine (Pen). Nanoindentation was used to assess bone-tissue stiffness in three directions, and multiple linear regressions were used to calculate the correlation between collagen properties and bone-tissue stiffness, with the DMB as first predictor. Whereas the bone-tissue stiffness of cancellous bone did not differ between the three directions of nanoindentation, or between the two age groups, cortical bone-tissue stiffness was higher in the adult tissue. After correction for DMB, the cross-links studied did not increase the explained variance. In the young group, however, LP significantly improved the explained variance in bone-tissue stiffness. Approximately half of the variation in bone-tissue stiffness in cancellous and cortical bone was explained by the DMB and the LP cross-links and thus they cannot be considered the sole determinants of the bone-tissue stiffness.

  1. Transparotid approach for mandibular condylar neck and subcondylar fractures.

    Science.gov (United States)

    Croce, A; Moretti, A; Vitullo, F; Castriotta, A; Rosa, De M; Citraro, L

    2010-12-01

    Mandibular condylar neck fractures and subcondylar fractures represent, respectively, 19-29% and 62-70% of all mandibular fractures; treatment involves some problems, common to both, concerning the choice of an adequate approach. Herewith, personal experience is reported related to the surgical treatment of some cases of mandibular condylar neck and subcondylar fractures by transparotid approaches with partial parotidectomy, removing the salivary tissue overlying the condylar neck and/or the subcondylar region. Over the last 5 years, we observed 22 fractures of the condylar neck and 10 fractures of the subcondylar region. In 13 patients (11 male, 2 female, age range 10-68 years, mean 33 years), 10 of whom had other mandibular and/or other maxillo-facial and skeleton fractures - 50% of these with dislocated condylar heads - and the other 3 for their free choice, regarding the different treatments, 18 transparotid approaches with partial parotidectomy (bilateral in 5 cases), were performed reducing and fixing 12 condylar neck fractures and 5 subcondylar region fractures with appropriate plates (2.0 mm) and screws. After surgery, no intermaxillary fixation was performed. Complications included 4 salivary fistulae (bilateral in 1 patient), which closed spontaneously after 4 or 5 weeks with a dressing, 1 case of Frey's syndrome, which healed after 2 treatments with botulin and 6 cases of transient facial palsy lasting 4-8 weeks (1 case bilateral) affecting zygomatic, buccal and marginal mandibular nerves. During follow-up, functional parameters considered were: restoration of original pre-injury occlusion; vertical, lateral and protrusion mandibular movements. All patients re-acquired the original pre-injury occlusion; the maximal post-operative intrinsical distance was at least 40 mm after a variable period of rehabilitation and lateral and protrusion movements also led to satisfactory final results. All patients were free of pain and had no deflection or clicking upon

  2. Osteochondral Fracture Lateral Femoral Condyle Treated with ORIF Using Z-Plasty: A Modification of Coonse and Adams Approach

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    Sanjay Agarwala

    2011-01-01

    Full Text Available Osteochondral fractures of lateral femoral condyle are common in adolescents and young adults. They are usually caused by direct trauma or twisting injuries of the knee. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. Adequate exposure was achieved by doing Z-plasty of quadriceps apparatus. The fracture was treated with open reduction and internal fixation using Herbert's screws. Medical management in the form of vitamin D and calcium along with testosterone was given. After the surgery, full weight-bearing was allowed at three months. At one year followup, patient has good quadriceps function without any weakness of the muscle.

  3. Evaluation of temporomandibular fossa and mandibular condyle in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography.

    Science.gov (United States)

    Uçar, Faruk Izzet; Buyuk, Suleyman Kutalmış; Şekerci, Ahmet Ercan; Celikoglu, Mevlut

    2016-11-01

    The purposes of this study were to investigate the position of the mandibular condyle and temporomandibular fossa between the adolescent patients affected by bilateral cleft lip and palate (BCLP) and well-matched controls without any cleft by using cone-beam computed tomography (CBCT). The study sample consisted of 17 patients (7 females and 10 males; mean age, 14.27 ± 2.83 years) affected by BCLP and 17 patients (6 females and 11 males; mean age, 14.27 ± 2.12 years) as age-and sex-matched control group without any cleft. Using cone-beam computed tomography segmented three-dimensional temporomandibular fossa and mandibular condyle images were reconstructed and angular, linear, and volumetric measurements of the patients in both sides of the groups were examined using Paired and Student's t-tests. Comparison of the sides showed that both sides were found to be similar in BCLP and control groups, except the condylar angulation of the right side was found to be higher compared to that of the left side in both groups (p condylar angulation in the right side (BCLP group had less angulation compared to controls; p condylar volume was found to be slightly less in the BCLP group in both sides compared to the controls (p > 0.05). The positions of the mandibular condyle and temporomandibular fossa were found to be similar in patients affected by BCLP and control group of without any cleft. SCANNING 38:720-726, 2016. © 2016 Wiley Periodicals, Inc.

  4. Epidemiological analysis of mandibular fractures treated in Sao Paulo, Brazil

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    Kelly Marinho

    2015-10-01

    Conclusion: The treatment of mandibular fractures should be aimed at restoring the occlusion and mastication function, with surgery being the most indicated treatment, using reduction and internal fixation with the use of a plates and screws system based on the experience of the authors. Knowledge of surgical techniques and methods of reduction and fixation of fractures, and periodic monitoring allow these patients to receive the appropriate treatment.

  5. Iatrogenic Mandibular Fracture Associated with Third Molar Removal

    Directory of Open Access Journals (Sweden)

    Abdulkadir Burak Cankaya, Mehmet Ali Erdem, Sirmahan Cakarer, Muhsin Cifter, Cuneyt Korhan Oral

    2011-01-01

    Full Text Available Third molar extraction is one of the most common procedures performed in oral and maxillofacial surgery units. It is sometimes accompanied by complications such as alveolar osteitis, secondary infection, hemorrhage, dysesthesia and, most severely, iatrogenic fracture. This article describes two mandibular angle fractures that occurred in two patients during the surgical extraction of one erupted and one unerupted third molar, including a brief review of the literature.

  6. Iatrogenic Mandibular Fracture Associated with Third Molar Removal

    OpenAIRE

    Abdulkadir Burak Cankaya, Mehmet Ali Erdem, Sabri Cemil Isler, Sabit Demircan, Merva Soluk, Cetin Kasapoglu, Cuneyt Korhan Oral

    2011-01-01

    Third molar extraction is one of the most common procedures performed in oral and maxillofacial surgery units. It is sometimes accompanied by complications such as alveolar osteitis, secondary infection, hemorrhage, dysesthesia and, most severely, iatrogenic fracture. This article describes two mandibular angle fractures that occurred in two patients during the surgical extraction of one erupted and one unerupted third molar, including a brief review of the literature.

  7. Delayed presentation of popliteal artery transection following undisplaced lateral condyle fracture of tibia

    Directory of Open Access Journals (Sweden)

    Mohit Gupta

    2016-01-01

    Full Text Available Literature suggests that vascular damage occurring with orthopedic injury of the lower extremity is rare and uncommon. We present a case of a young adult male who presented to the emergency room with a history of road traffic accident with complaints of pain in the right ankle diagnosed as medial malleolus fracture and pain in the left knee diagnosed as undisplaced lateral tibial condyle fracture. At the time of presentation, the left leg appeared normal and was stabilized with a knee brace, which on the next day developed severe swelling with absence of distal pulses. Doppler revealed no blood flow distal to popliteal artery with severe soft tissue edema. The patient was posted for emergency basis vascular exploration where popliteal artery was surprisingly found transected and was repaired followed by timely fasciotomy. This case report has also been prepared to stress the importance of secondary survey in patients after high energy trauma as it can prevent the important injuries from being missed.

  8. Clinical outcomes of surgical management of anterior bilateral mandibular fractures

    NARCIS (Netherlands)

    Boffano, P.; Gallesio, C.; Roccia, F.; van den Bergh, B.; Forouzanfar, T.

    2013-01-01

    Purpose: The aims of this study were to assess the clinical outcomes of patients with anterior bifocal mandibular fractures and to discuss the management of this peculiar type of trauma. Methods: From the systematic computer-assisted database that has continuously recorded patients hospitalized with

  9. Clinical outcomes of surgical management of anterior bilateral mandibular fractures

    NARCIS (Netherlands)

    Boffano, P.; Gallesio, C.; Roccia, F.; van den Bergh, B.; Forouzanfar, T.

    2013-01-01

    Purpose: The aims of this study were to assess the clinical outcomes of patients with anterior bifocal mandibular fractures and to discuss the management of this peculiar type of trauma. Methods: From the systematic computer-assisted database that has continuously recorded patients hospitalized with

  10. Management of fractures of the mandibular body and symphysis.

    Science.gov (United States)

    Goodday, Reginald H B

    2013-11-01

    Mandibular fracture, specifically in the symphysis and body regions combined, is the most common facial fracture requiring hospitalization in North America. The primary treatment objective is to restore form and function by achieving anatomic reduction and placing fixation that eliminates mobility of the bone fragments. Several treatment options and surgical techniques are available for performing closed or open reduction. Special considerations are necessary when treating pediatric patients and fractures of the edentulous mandible. Complications relating to the tooth and denture-bearing regions of the mandible include infection, nonunion, and neurosensory changes.

  11. TREATING CONDYLE FRACTURE WITH OPEN OPERATION%切开复位治疗髁状突骨折

    Institute of Scientific and Technical Information of China (English)

    谭卫明; 杨壮群; 侯成群; 白岫峰; 常晓峰; 齐岩

    2001-01-01

    Objective: To discuss the method and probability of using open operation to treat condyle fracture. Methods:Open operation passing through before tragu incision or submandibular incisions, The condyle fracture included realignment of the bone ends ,fixation and repairment of capsula articularis. Results :Sixteen cases and twenty sides of condyle fracture were treated by open operation. The survey had been kept on fixation for 4 months. It indicated that there were no joint disturbances and facial paralysis, the form and function of mandibules were nearly normal. Conclusion: We can acquire satisfactory result from treating condyle fracture outside of capsula articularis by open operation using osteosynthesis%目的:探讨髁状突骨折手术治疗的途径和可行性。方法:采用耳屏前入路或耳屏与颌下联合入路进行髁状突的复位、固定及关节囊的修复。结果:本组16例共20侧经术后平均4个月的随访,面部形态基本对称,张口度正常,无关节紊乱及面神经功能障碍。结论:关节囊外移位性髁状突骨折采用切开复位坚固内固定方法治疗,可取得较满意的临床疗效。

  12. Management of mandibular body fractures in pediatric patients: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Baby John

    2010-01-01

    Full Text Available Mandibular fractures are relatively less frequent in children when compared to adults, which may be due to the child′s protected anatomic features and infrequent exposure of children to alcohol related traffic accidents. Treatment principles of mandibular fractures differ from that of adults due to concerns regarding mandibular growth and development of dentition. A case of a 4.5-year-old boy with fractured body of mandible managed by closed reduction using open occlusal acrylic splint and circum mandibular wiring is presented. This article also provides a review of literature regarding the management of mandibular body fracture in young children.

  13. Mandibular fracture with a mouth formed mouthguard in kickboxing.

    Science.gov (United States)

    Shimoyama, Tetsuo; Masuda, Issei; Numa, Takehiro; Horie, Norio

    2009-04-01

    Reports of injuries caused by kickboxing, one of the contact sports that potentially causes a large number of injuries, are relatively rare. Wearing a mouthguard is obligatory in kickboxing, but the association between maxillofacial injuries and the quality of mouthguards has not been described thus far. In this article, we present a case of mandibular fracture in a 25-year-old male, who was injured during kickboxing despite wearing a mouth formed mouthguard.

  14. Management of Pediatric Mandibular Fracture Using Orthodontic ...

    African Journals Online (AJOL)

    2017-05-22

    May 22, 2017 ... of occlusion, step at the 41, 31 region [Figure 1], and a vertical ... was no individual tooth fracture present and no tooth in the line of ... manually and aligned by bi-digital pressure with the guidance of the ... bone ratio.[6,7] ... and closed reduction, intermaxillary fixation (IMF), and splints. ... Thickness ranging ...

  15. [Miniplates in the treatment of mandibular fractures].

    Science.gov (United States)

    Gonzalez Garcia, A; Bermudo Añino, L; Valiente Alvarez, A; Mateo Garcia, J; Yañez Vilas, I

    1989-01-01

    We present in this paper the treatment of mandibule fractures with miniplates of titanium. The miniplates have provided stable fixation and compared with other techniques improved in all concepts. The complication rates have been very low: there were not infections. The stability of fixation avoid to block with elastic training. Therefore, meticulous techniques is mandatory with particular emphasis in passive fitling of the plates.

  16. Incidence of mandibular fractures in Eastern part of Libya.

    Science.gov (United States)

    Elgehani, Rafa-Abdelsalam; Orafi, Maraai-Idris

    2009-10-01

    The objective of this retrospective study is to evaluate the incidence of mandibular fractures in the eastern part of Libya and to present our experience in treating this type of facial fracture. We analyzed factors such as the incidence of age, sex, time distribution, cause and site of the fracture and the associated injuries in 493 patients presenting a total of 666 mandibular fractures. These patients were treated at Al-Jala Trauma Hospital, Benghazi-Libya between 2000 and 2006. The results were obtained from 432 males and 61 females, for which the ages ranged from 8 months to 72 years. The maximum number of the patients was recorded in 2004, and the busiest month was May. The most common cause of fracture was road traffic accidents and the most common site was the parasymphysis. Among those treated with closed reduction were 241 patients, whereas 201 patients were treated with open reduction. In conclusion, we found that the results were similar to most studies from developing countries and were in contrast to other studies. This may be due factors such as geography, socioeconomic trends, religion, road traffic legislation and seasons, which differ from one country to another. The period during which there was an embargo in Libya also appears to have affected the results.

  17. Spontaneous fracture of the mandibular genial tubercles. A case report.

    Science.gov (United States)

    Gallego, Lorena; Junquera, Luis; Villarreal, Pedro; de Vicente, Juan Carlos

    2007-12-01

    Fracture of the mandibular genial tubercles is an uncommon pathology affecting edentulous patients with severe maxillary atrophy. Usually occurs spontaneously which complicates the diagnosis. Their importance lies in the functional alterations, which occur as a consequence of the disinsertion of the genihyoid and genioglossus muscles. The treatment of fracture of the genial tubercles is controversial, including no surgical intervention, excision of the avulsed bone fragments, and muscular repositioning. There have been only 11 cases reported in the literature of this fracture, most of them spontaneous. We present a difficult diagnosis situation of spontaneous fracture of the genial tubercles in an 86-year-old edentulous female with a painful sublingual and submental hematoma and anterior cervical echimosis. Computerized Tomography should be made to confirm the diagnosis. Surgical treatment was not necessary, and follow-up at 6 months revealed complete symptomatic recovery, and full return of function.

  18. Etiology and management of mandibular fractures associated with endosteal implants in the atrophic mandible

    NARCIS (Netherlands)

    Raghoebar, GM; Stellingsma, K; Batenburg, RHK; Vissink, A

    2000-01-01

    Mandibular fractures can occur with the insertion of endosseous implants. Four patients whose mandibles were fractured with the removal or insertion of mandibular endosseous implants are described. Three of the patients required an autogenous bone graft to repair the fracture, and 1 patient was mana

  19. Kirschner wire fixation of Salter-Harris type IV fracture of the lateral aspect of the humeral condyle in growing dogs. A retrospective study of 35 fractures.

    Science.gov (United States)

    Cinti, Filippo; Pisani, Guido; Vezzoni, Luca; Peirone, Bruno; Vezzoni, Aldo

    2017-01-16

    To evaluate the use of Kirschner wires for treatment of fractures of the lateral aspect of the humeral condyle in growing dogs. Retrospective analysis of 35 elbow fractures (33 dogs) of the lateral aspect of the humeral condyle treated by insertion of multiple transcondylar and one anti-rotational Kirschner wires. Radiographic and clinical re-evaluations were carried out immediately after surgery, at four weeks and, when required, at eight weeks postoperatively. Long-term follow-up was planned after a minimum of six months. The relationship between different implant configurations and clinical outcome was analysed statistically. Complete functional recovery was seen in 31 elbows (30 dogs), three elbows (2 dogs) had reduction in the range of motion, and one elbow (1 dog) had persistent grade 1 lameness two months postoperatively. Major complications occurred in eight elbows (8 dogs) and all were resolved by implant removal. Implant configuration did not affect outcome. Long-term evaluation in 12 cases with a mean follow-up of four years showed absence of lameness, normal function and no or mild radiographic evidence of osteoarthritis in 11 cases. Fracture of the lateral aspect of the humeral condyle in growing dogs can be successfully treated by multiple transcondylar convergent or parallel Kirschner wires, resulting in adequate fracture healing.

  20. Mandibular Angle Fractures: Comparison of One Miniplate vs. Two Miniplates

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    Saeed Hajmohammadi

    2013-01-01

    Full Text Available Background: Monocortical miniplate fixation is an accepted and reliable method for internal fixation of mandibular angle fractures. Although placement of a second miniplate may theoretically provide more stability; however, the clinical importance of this issue remains controversial.Objectives: The present study assessed the postoperative complications and outcomes associated with the fixation of mandibular angle fractures using 1 and 2 miniplates in patients with favorable mandibular angle fractures.Patients and Methods: A prospective study of 87 patients (73 males, 14 females with favorable mandibular angle fractures was done. In the first group, a 4-hole miniplate was placed at the superior border through an intraoral approach. In group 2, patients were treated with 2 miniplates, one placed at the superior border (similar to group 1 and the other on the lateral aspect of the angle at the inferior border through an intraoral and transcutaneous approach using a trocar. Postoperative complications including malocclusion, malunion and sensory disturbances associated with surgery, additional maxillomandibular fixation (MMF by means of an arch bar and wires for a longer period (for delayed union and infection were assessed in patients of both groups up to 12 months postoperatively. The data were analyzed using the chi-square test.Results: In the single miniplate group, 25 patients showed lip numbness associated with surgery (55.6%, 22 patients required additional use of MMF (48.9% and 3 patients developed infections (6.7%. In the double miniplate group 20 patients showed lip numbness associated with surgery (47.6%, 18 patients required additional use of MMF (42.9% and 1 patient developed infection (2.4%. None of the patients in either group showed malocclusion or malunion. No significant difference was observed between the groups regarding overall complication rate.Conclusions: In this study, use of one miniplate or two miniplates for treatment of

  1. Fractures of the occipital condyle clinical spectrum and course in eight patients

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    Antonio Krüger

    2013-01-01

    Full Text Available Introduction: Occipital condyle fractures (OCFs are considered to be rare injuries. OCFs are now diagnosed more often because of the widespread use of computed tomography. Our aim is to report the incidence, treatment and long term outcome of 8 patients with OCFs. Materials and Methods: All patients presenting with multiple trauma from 1993 to 2006 were analyzed retrospectively. Characteristics and course of the treatment were evaluated. Follow-up was performed after 11,7 years (range 5,9 to 19,3 years. Results: Nine cases of OCF in 8 patients were identified. All injuries resulted from high velocity trauma. The average scores on the ISS Scale were 39,6 (24-75 and 7,3 (3-15 on the GCS. According to Anderson′s classification, 5 cases of Type III and 4 cases of Type I fractures were identified. According to Tuli′s classification, 5 cases of Type IIA and 4 cases of Type I were found. Indications for immobilization with the halo-vest were type III injuries according to Anderson′s classification or Tuli′s type IIA injuries, respectively. Patients with Tuli′s type I injuries were treated with a Philadelphia collar for 6 weeks. In one patient with initial complete tetraplegia and one with incomplete neurological deficits the final follow-up neurologic examination showed no neurological impairment at all (Frankel-grade A to E, respectively B to E. At follow-up, 3 patients were asymptomatic. Four patients suffered from mild pain when turning their head, pain medication was necessary in one case only. Discussion: OCF`s are virtually undetectable using conventional radiography. In cases of high velocity, cranio-cervical trauma or impaired consciousness, high resolution CT-scans of the craniocervical junction must be performed. We suggest immobilization using a halo device for type III injuries according to Anderson′s classification or Tuli′s type IIa injuries, respectively. Patients with Tuli′s type I injuries should be treated with a

  2. LATE OPEN REDUCTION AND INTERNAL FIXATION FOR FRACTURES OF LATERAL CONDYLE OF HUMERUS IN CHILDREN: A CLINICAL STUDY

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    Ajay

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Neglected fracture of the lateral condyle of distal humerus in children is very common. Patients with non union of the lateral condylar fracture have pain, instability or a progressive cubitus valgus deformity, condylar prominence. A neglected displaced lateral humeral condyle fracture remains a difficult problem to treat. The bone ends become indistinct and soft tissue becomes contracted; making anatomic reduction difficult. Moreover a n attempt to mobilize the fragment by stripping the soft tissues may lead to avascular necrosis. Several authors have recommended operative treatment for such patients, while others do not recommend operative intervention because stiff elbow and AVN are th e usual outcomes. The present study was undertaken to assess the results of open reduction and internal fixation in neglected lateral humeral condyle fracture in children. MATERIAL AND METHODS : This is a prospective study carried out between November 2008 and July 2011 in the department of orthopedics at Teerthanker Mahaveer Medical College and research centre, Moradabad. Eighteen patients (14M:4F with an average age of 7.3years (range 5.5 to 14 years who had lateral humeral condyle fracture and reporte d 3 or more weeks after sustaining injury, were included in the study. The fractures were classified according to the Jacobs system. All patients were operated using the lateral approach and fixation was done using K wire or screw with or without bone graf ting. The results were graded as excellent, good, fair or poor according to the modified criteria of Agarwal et al. RESULTS : There were 14 males and 4 females with a mean age of 7 years and 3 months (range 4 - 14 years. Among the nine (50% patients who pr esented between 5 to 8 weeks after injury, the results were excellent in 3, good in 4, fair in 1 and poor in 1 patient. Excellent to good results were seen in all the five (27% patients presenting between 3 - 5 weeks of injury. Among

  3. Modified endaural approach for the treatment of condylar fractures: A review of 75 cases

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    S M Balaji

    2016-01-01

    Conclusion: Surgery for mandibular condyle fractures with modified approach allows direct vision of the fracture and reduces surgical trauma to the site while avoiding permanent facial nerve injury. Hence, the author's modified Al-Kayat Bramley incision via endaural approach could be considered as the best approach for open reduction and internal fixation of condylar neck and subcondylar mandibular fractures.

  4. Influence of third molars in mandibular fractures. Part 1: mandibular angle-a meta-analysis.

    Science.gov (United States)

    Armond, A C V; Martins, C C; Glória, J C R; Galvão, E L; Dos Santos, C R R; Falci, S G M

    2017-06-01

    The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars on angle fractures. An electronic search was conducted in the PubMed, Scopus, Web of Science, Cochrane Library, and VHL databases, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 35 studies were included in the systematic review and 28 in the meta-analysis. Twenty studies presented a score of ≤6 stars in the Newcastle-Ottawa scale assessment, indicating a risk of bias in the analysis. The presence of a mandibular third molar increases the chance of an angle fracture (case-control and cross-sectional studies: odds ratio (OR) 3.83, 95% confidence interval (CI) 3.02-4.85, I(2)=83.1%; case-control studies: OR 3.27, 95% CI 2.57-4.16, I(2)=81.3%). The third molar positions most favourable to angle fracture according to the Pell and Gregory classification are class B (OR 1.44, 95% CI 1.06-1.96, I(2)=87.2%) and class II (OR 1.67, 95% CI 1.36-2.04, I(2)=72.4%). Class A (OR 0.60, 95% CI 0.45-0.81, I(2)=87.1%) and class I (OR 0.51, 95% CI 0.37-0.71, I(2)=89.4%) act as protective factors for angle fracture. The results suggest that the presence of the third molar increases the chance of angle fracture by 3.27 times and that the most favourable positions of the third molar for angle fracture are classes B and II, whilst classes A and I act as protective factors. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Effect of early or delayed treatment upon healing of mandibular fractures: a systematic literature review

    DEFF Research Database (Denmark)

    Hermund, Niels Ulrich; Hillerup, Søren; Kofod, Thomas

    2008-01-01

    The possible relation between treatment delay and healing complications in mandibular fracture treatment (excluding condylar fractures) was reviewed systematically. Twenty-two studies were identified. No randomized studies focused on the effect of immediate or delayed treatment. The main focus...

  6. Internal fixation of mandibular angle fractures: a meta-analysis.

    Science.gov (United States)

    Regev, Eran; Shiff, Jacob S; Kiss, Alex; Fialkov, Jeffrey A

    2010-06-01

    The degree of rigidity of internal fixation required for the treatment of mandibular angle fractures has long been at the center of debate in the literature. A statistical comparison between rigid fixation and monocortical fixation has been difficult because of multiple terms, definitions, and technical variations. The purpose of this study was to use the meta-analysis tool to combine information from multiple studies and to compare complication rates for different fixation methods. An English language literature search was conducted for articles on mandibular angle fractures. Information was collected on four variables of interest: compression/noncompression technique, monocortical/bicortical screws, number of plates, and location of plates. Five outcome rates were analyzed: infection, reoperation, hardware removal, malunion, and nonunion. Meta-analyses were run using Comprehensive Meta Analysis, version 2.2.03. Twenty-four studies with relevant data on the variables and outcomes of interest met the inclusion criteria. Significantly higher rates of infection, reoperation, and hardware removal were found for compression compared with noncompression, two plates compared with one plate, and for plates located on both the inferior and superior borders as compared with superior or inferior only. There were also significantly higher infection rates for bicortical screws compared with monocortical screws and higher malunion rates for compression compared with noncompression plating techniques. The results of this meta-analysis found lower complication rates with the use of noncompression, monocortical, and single-plate fixation, supporting the trend toward a single, superiorly placed, monocortical miniplate for fixation of mandibular angle fractures.

  7. Tratamento cirúrgico da fratura do côndilo occipital: relato de caso Surgical treatment of the occipital condyle fracture: case report

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    Sebastião Silva Gusmão

    2001-03-01

    Full Text Available Apresentamos um caso de fratura do côndilo occipital tratada cirurgicamente, que se manifestou por cervicalgia, lesão dos nervos IX, X e XII e síndrome piramidal dos quatro membros. É realizada revisão da literatura sobre o tratamento cirúrgico da fratura do côndilo occipital.We present a case of fracture of the occipital condyle showing neck pain, lesion of IX, X and XII cranial nerves and pyramidal syndrome of the four members. A review of the literature about the surgical treatment of the occipital condyle fracture is done.

  8. Combined treatment of mandibular condylar fractures with mandibular and mandibular fractures with full dentition and elastic jaw cap%全牙列牙合垫结合弹性吊颌帽治疗替牙期下颌骨髁状突骨折

    Institute of Scientific and Technical Information of China (English)

    张永宽; 王兴强; 王维玺; 荆欢欢

    2015-01-01

    目的:探讨全牙列牙合垫式保持器及吊颌帽弹性牵引在替牙期儿童髁状突骨折治疗的价值。方法:选取19例替牙期下颌骨髁状突骨折合并上颌前牙外伤性松动的患者,用全牙列牙合垫式保持器结合吊颌帽弹性牵引进行治疗。结果:所有患儿松动牙固定良好,咬合关系正常,无张口受限。X线片骨折复位良好。结论:全牙列牙合垫式保持器结合吊颌帽弹性牵引是一种治疗替牙期儿童下颌骨髁状突状突骨折的有效方法。%Objective To investigate effect of full denture teeth plate retainer and elastic traction in the treatment of condyle fracture in mixed dentition period children. Methods 19 cases with mandibular condyle fracture combined with maxillary anterior teeth loose,treated with full denture teeth plate re⁃tainer and elastic traction. Results All children with loose tooth fixed good,occlusal relationship was normal,no limited mouth opening,Fracture healing was good by X-ray radiograph. Conclusion Treat⁃ed with full denture teeth plate retainer and elastic traction is a kind of treatment for mandibular con⁃dyle fracture in the mixed dentition period children.

  9. Terapêutica interdisciplinar para fratura cominutiva de côndilo por projétil de arma de fogo: enfoque miofuncional Interdisciplinary approach for comminuted condyle fracture of by firearms: myofunctional focus

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    Esther Mandelbaum Gonçalves Bianchini

    2010-10-01

    áticas.BACKGROUND: firearm wounds are relatively frequent and show high incidence at the head and face area. Temporomandibular joint may be involved, and also some important anatomic structures as the facial nerve directing the need for an interdisciplinary team in order to promote an efficient treatment. PROCEDURES: a case report related to a comminuted condyle fracture caused by firearms with a nonsurgical treatment associated to myofunctional therapy. The patient was referred to Speech and Language Pathologist after the conduct of oral and maxillofacial surgery team, without removing the bullet, lodged superficially near the origin of the sternocleidomastoid muscle on the right side; with comminuted condyle fracture and facial nerve damage. Myofunctional evaluation found an important reduction in the mandibular movement amplitude with severe deviations as for the affected side, no contralateral laterality, muscle pain; paralysis and paresthesia on the right side of the face. Myofunctional therapy followed a specific protocol for facial trauma including: drainage of edemas, specific ipsilateral manipulations on jaw muscles; correction and enlargement of the mandibular movements, specific procedures related to facial paralysis and directed functional reorganization. RESULTS: after eight therapy sessions we obtained: mandibular movements with adequate amplitude and symmetry, chewing reorganization, adequacy of swallowing and speech, remission of painful symptoms and remission of paralysis in the medium third of the face. CONCLUSION: the conservative treatment for comminuted condyle fracture through myofunctional therapy resulted in functional rehabilitation of the jaw and face, directing the movements and stimulating the adequacy of the sthomatognatic functions.

  10. Complete resection and immediate reconstruction with costochondral graft for recurrent aneurysmal bone cyst of the mandibular condyle.

    Science.gov (United States)

    Ziang, Zhuo; Chi, Yang; Minjie, Chen; Yating, Qiu; Xieyi, Cai

    2013-11-01

    Aneurysmal bone cyst is a non-neoplastic expansile lesion characterized by replacement with fibro-osseous tissue and blood-filled cavernous spaces. Involvement of the condyle is rare, and only 11 cases have been reported in English-language literature to date. Its common treatment modalities are lesion excision or condylar resection, but recurrence is high in patients treated with the former. The authors reported a 19-year-old female patient with swelling of the right preauricular region, who had a surgical curettage history in another hospital. The lesion was completely resected and the jaw was immediately reconstructed with costochondral graft with the help of SurgiCase software. The patient has been symptom-free for 6 months postoperatively.

  11. Analysis of mandibular condylar and glenoid fossa fractures with computed tomography

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    Ogura, Ichiro; Sasaki, Yusuke; Kaneda, Takashi [Nihon University School of Dentistry at Matsudo, Department of Radiology, Matsudo, Chiba (Japan)

    2014-04-15

    The purpose of this study was to investigate the prevalence of glenoid fossa and condylar fractures in patients with mandibular fractures using multidetector computed tomography (MDCT). A prospective study was performed in 227 patients with mandibular fractures who underwent 64-MDCT. Mandibular fractures were classified into four types: median, paramedian, angle and condylar. Statistical analysis of the relationship between prevalence of condylar fractures and mandibular fracture locations was performed using χ{sup 2} test with Fisher's exact test. A P value less than 0.05 was considered statistically significant. The prevalence of condylar fracture was 64.8 % of all patients with mandibular fractures, 66.7 % of median type (P = 0.667), 45.5 % of paramedian type (P = 0.001) and 12.3 % of angle type (P = 0.000), respectively. Furthermore, glenoid fossa fracture was seen in 1.4 % of patients with condylar fractures. The results of the presented study suggest focusing also on incidental findings such as glenoid fossa fractures. (orig.)

  12. Additive Manufacturing for Surgical Planning of Mandibular Fracture.

    Science.gov (United States)

    Brito, Nadja Maria da Silva Oliveira; Soares, Renata de Souza Coelho; Monteiro, Erik Lafitt Tavares; Martins, Sergio Charifker Ribeiro; Cavalcante, Josuel Raimundo; Grempel, Rafael Grotta; Neto, José Augusto de Oliveira

    2016-12-01

    Currently, imaging techniques such as Computed Tomography with three-dimensional reconstruction (3D) and Magnetic Resonances are being routinely used in pre-surgical planning in all fields of medicine. Nowadays, virtual three-dimensional images, commonly displayed on two-dimensional surfaces, such as the computer screen, can be used to produce rapidly prototyped models, with excellent dimensional accuracy and fine reproduction of anatomical structures, providing professionals with the ability to use the biomodel in planning and simulating medical and dental procedures (oral and maxillofacial surgery, making individualized facial implants and prostheses, measurements and previous adaptations of prefabricated fixation plates), thus contributing to considerable reductions in surgical time and consequently the duration of anesthesia, minimizing infection risks and reducing hospital costs. In this report, we describe a case of surgical planning and treatment of bilateral atrophic mandibular fracture, in which, for surgical planning, authors used Rapid Prototyping as an adjunct tool, considering the advantages already outlined.

  13. Analysis of two different surgical approaches for fractures of the mandibular condyle

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    S Kumaran

    2012-01-01

    Results: Dental occlusion was restored in all the cases, and good anatomical reduction was achieved. The mean operating time was higher 63.53 (mean ± 18.12 minutes standard deviation (SD in the preauricular approach compared to 45.22 (mean ± 18.86 minutes SD in the mini retromandibular approach. Scar formation was satisfactory in almost all the cases.

  14. Delayed Operative Management of Fractures of the Lateral Condyle of the Humerus in Children

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    Shabir AD

    2015-03-01

    Full Text Available Purpose; Delayed presentation of lateral condylar fractures of the humerus is relatively common in the developing regions of the world. These fractures are difficult to manage because of the displacement and fibrosis around the condylar fragment secondary to the delay. There is a paucity of literature concerning the management of these fractures. An oft repeated finding is the requirement of extensive dissection around the fragment for proper reduction. The purpose of this study was to assess the efficacy of surgical management of lateral condylar fractures with delayed presentation. Methods; We assessed the results of lateral condylar fracture fixation in 20 cases with delayed presentation. Results; The lateral condylar fractures in patients with a delayed presentation can be managed surgically with good results. Conclusions; Open reduction and internal fixation should continue to be the method of choice for the management of lateral condylar fractures which report late for management.

  15. Clinical and radiographic evaluation of biodegradable bone plates in the treatment of mandibular body fractures

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    Sherin Kamal Elhalawany

    2015-01-01

    Full Text Available Background: Many different systems are available for the treatment of fractures ranging from the heavy compression plates for mandibular reconstruction to low profile plates for mid-facial fixation, and are made either from stainless steel, titanium or vitallium. Recently, biodegradable, self-reinforced polylactide plates and screws have been used for the internal fixation of fractures of the mandible with good results. Aim of this study: This study evaluated clinically the biodegradable bone plates for treatment of mandibular body fracture and to evaluate bone healing during the follow-up period using digital radiography. Materials and Methods : Eight patients had been suffered from mandibular body fractures were treated using Inion CPS TM bioresorbable fixation system and the healing process were followed up using digitised panoramic radiography at first week and after 1, 3 and 6 months. Results: Clinical examination of fractured segments revealed stable fixation across the fracture sites while visual and quantitative assessment of radiograph showed healing process was comparable with results previously reported by titanium bone plates. Conclusion: Open reduction and internal fixation of mandibular fractures using bioresorbable fixation system with a brief period of inter-maxillary fixation have evolved to the point where the physical properties are sufficient to withstand the post-operative loads required for fracture repair of mandibular body fractures. The foreign body reaction is a major material-related problem which requires further studies.

  16. Endodontic management of a two rooted, three canaled mandibular canine with a fractured instrument

    National Research Council Canada - National Science Library

    Jadhav, Ganesh Ranganath

    2014-01-01

    .... This case reports the use of dental operating microscope for the successful endodontic management of a two rooted and three canaled mandibular canine with the fractured instrument in the middle canal...

  17. INCIDENCE, ETIOLOGY AND PATTERN OF MANDIBULAR FRACTURE IN CIMS, BILASPUR, CG, INDIA

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    Singh

    2015-10-01

    Full Text Available The aim of this study was to determine the incidence, etiology of mandibular fractures among different age and sex group to determine the frequency of anatomical distribution of fracture site. The study was conducted in the Department of ENT in associatio n with Department of Dentistry, CIMS, and Bilaspur. We included total 100 patients particularly with mandibular fracture and associated maxillofacial injuries. These patients were treated at Chhattisgarh Institute of Medical Sciences, Bilaspur from May 201 2 to April 2015. Among these 100 patients the most common cause of mandib le fracture is Road Traffic Acc idents with parasymphysis fracture as most common site. Incident of Mandibular fracture is mainly observed in male patients with 20 – 30 years of age group

  18. Posttraumatic Mandibular Asymmetry Presenting in a Young Adult

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    Mahnaz Sheikhi, DDS,MS

    2017-03-01

    Full Text Available One of the most common sites of injury of the facial skeleton is mandibular condyle. However, it is the least diagnosed site of trauma in the head and neck regions. A trauma to the mandible and specifically condylar zone during childhood, may lead to asymmetry or mandibular bilateral distortion, which is usually manifested in the second decade of life when the etiology is unknown to most people. This report is about an adult male complaining about facial asymmetry with an unknown source. Obvious clicking at the right side and shorter right ramus and condyle's head deviation directed us to a childhood trauma and fracture.

  19. A novel computer algorithm for modeling and treating mandibular fractures: A pilot study.

    Science.gov (United States)

    Rizzi, Christopher J; Ortlip, Timothy; Greywoode, Jewel D; Vakharia, Kavita T; Vakharia, Kalpesh T

    2017-02-01

    To describe a novel computer algorithm that can model mandibular fracture repair. To evaluate the algorithm as a tool to model mandibular fracture reduction and hardware selection. Retrospective pilot study combined with cross-sectional survey. A computer algorithm utilizing Aquarius Net (TeraRecon, Inc, Foster City, CA) and Adobe Photoshop CS6 (Adobe Systems, Inc, San Jose, CA) was developed to model mandibular fracture repair. Ten different fracture patterns were selected from nine patients who had already undergone mandibular fracture repair. The preoperative computed tomography (CT) images were processed with the computer algorithm to create virtual images that matched the actual postoperative three-dimensional CT images. A survey comparing the true postoperative image with the virtual postoperative images was created and administered to otolaryngology resident and attending physicians. They were asked to rate on a scale from 0 to 10 (0 = completely different; 10 = identical) the similarity between the two images in terms of the fracture reduction and fixation hardware. Ten mandible fracture cases were analyzed and processed. There were 15 survey respondents. The mean score for overall similarity between the images was 8.41 ± 0.91; the mean score for similarity of fracture reduction was 8.61 ± 0.98; and the mean score for hardware appearance was 8.27 ± 0.97. There were no significant differences between attending and resident responses. There were no significant differences based on fracture location. This computer algorithm can accurately model mandibular fracture repair. Images created by the algorithm are highly similar to true postoperative images. The algorithm can potentially assist a surgeon planning mandibular fracture repair. 4. Laryngoscope, 2016 127:331-336, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  20. Reattachment of fractured teeth fragments in mandibular incisors: a case report

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    Yousef MK

    2015-04-01

    Full Text Available Mohammed K YousefDepartment of Operative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi ArabiaAbstract: The majority of dental trauma involves anterior teeth, especially the maxillary central incisors. A mandibular incisor fracture with or without pulp tissue involvement is considerably less common. Different approaches for treating these fractured teeth have been reported in the literature. The type of treatment rendered depends mainly on the extent of fracture, pulp involvement, radicular fracture, biologic width infringement or violation, and presence of the fractured piece. This case report illustrates reattachment of fractured fragments on two mandibular incisors without pulp exposure using a new proposed reattachment method using a combination of two different types of composite materials together with an orthodontic lingual retention wire. An 8-year-old female patient presented with fractured mandibular left incisors (Ellis class II fracture. Broken pieces were saved and brought in a closed container in water. Periapical radiographs revealed no evidence of pulpal involvement in either tooth and no periapical radiolucency was noticed. Fractured fragments and the broken teeth were prepared with circumferential bevels. Reattachment of the fractured fragments were done using two types of composite resin materials and a lingual orthodontic retention wire was also used. The patient was recalled after 8 months to follow up both teeth. Clinical examination revealed excellent composite restorations covering the fracture lines.Keywords: reattachment, fractured teeth, dental trauma 

  1. Effect of lower third molars on the incidence of mandibular angle and condylar fractures.

    Science.gov (United States)

    Choi, Byung-Joon; Park, Soong; Lee, Deok-Won; Ohe, Joo-Young; Kwon, Yong-Dae

    2011-07-01

    Numerous previous studies already have proven that mandibles with a third molar are significantly more susceptible to angle fracture by external force. Similarly, other data suggest that the absence of a third molar increases the risk of condylar fracture, while concurrently decreasing the risk of angular fracture. We attempt to characterize the effect of a third molar on the incidence of mandibular angle and condylar fractures. This retrospective study reviews data from 385 patients, all of whom were seen in our clinics between February 2006 and November 2009. All data were collected from clinical examination notes and panoramic radiographs, with third-molar state evaluated by the Pell and Gregory classification system. Our results mirror those of previous studies. The incidence of mandibular angle fracture was significantly greater on sides with a third molar, whereas the condylar fracture rate significantly increased in mandibles lacking a third molar or without a fully erupted third molar. The rate of symphysis and mandibular angle fracture was also high in cases of multiple comorbid fractures. Both the presence and the state of the lower third molar affect the risk of future mandibular angle and condylar fracture.

  2. Occipital Condyle Fracture with Accompanying Meningeal Spinal Cysts as a result of Cervical Spine Injury in 15-Year-Old Girl

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    Łukasz Wiktor

    2015-01-01

    Full Text Available The occipital condyle fracture is rare injury of the craniocervical junction. Meningeal spinal cysts are rare tumors of the spinal cord. Depending on location, these lesions may be classified as extradural and subdural, but extradural spinal cysts are more common. We present the case of a 15-year-old girl who suffered from avulsion occipital condyle fracture treated with use of “halo-vest” system. We established that clinical effect after completed treatment is very good. Control MRI evaluation was performed 12 months after removal of “halo-vest” traction, and clinically silent extradural meningeal spinal cysts were detected at the ventral side of the spinal cord in the cervical segment of the spine. Due to clinically silent course of the disease, we decided to use the conservative treatment. The patient remains under control of our department.

  3. Biomechanical Evaluation of a Mandibular Spanning Plate Technique Compared to Standard Plating Techniques to Treat Mandibular Symphyseal Fractures

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    Matthew Richardson

    2015-01-01

    Full Text Available Purpose. The purpose of this study is to compare the biomechanical behavior of the spanning reconstruction plate compared to standard plating techniques for mandibular symphyseal fractures. Materials and Methods. Twenty-five human mandible replicas were used. Five unaltered synthetic mandibles were used as controls. Four experimental groups of different reconstruction techniques with five in each group were tested. Each synthetic mandible was subjected to a splaying force applied to the mandibular angle by a mechanical testing unit until the construct failed. Peak load and stiffness were recorded. The peak load and stiffness were analyzed using ANOVA and the Tukey test at a confidence level of 95% (P<0.05. Results. The two parallel plates’ group showed statistically significant lower values for peak load and stiffness compared to all other groups. No statistically significant difference was found for peak load and stiffness between the control (C group, lag screw (LS group, and the spanning plate (SP1 group. Conclusions. The spanning reconstruction plate technique for fixation of mandibular symphyseal fractures showed similar mechanical behavior to the lag screw technique when subjected to splaying forces between the mandibular gonial angles and may be considered as an alternative technique when increased reconstructive strength is needed.

  4. Reattachment of fractured teeth fragments in mandibular incisors: a case report.

    Science.gov (United States)

    Yousef, Mohammed K

    2015-01-01

    The majority of dental trauma involves anterior teeth, especially the maxillary central incisors. A mandibular incisor fracture with or without pulp tissue involvement is considerably less common. Different approaches for treating these fractured teeth have been reported in the literature. The type of treatment rendered depends mainly on the extent of fracture, pulp involvement, radicular fracture, biologic width infringement or violation, and presence of the fractured piece. This case report illustrates reattachment of fractured fragments on two mandibular incisors without pulp exposure using a new proposed reattachment method using a combination of two different types of composite materials together with an orthodontic lingual retention wire. An 8-year-old female patient presented with fractured mandibular left incisors (Ellis class II fracture). Broken pieces were saved and brought in a closed container in water. Periapical radiographs revealed no evidence of pulpal involvement in either tooth and no periapical radiolucency was noticed. Fractured fragments and the broken teeth were prepared with circumferential bevels. Reattachment of the fractured fragments were done using two types of composite resin materials and a lingual orthodontic retention wire was also used. The patient was recalled after 8 months to follow up both teeth. Clinical examination revealed excellent composite restorations covering the fracture lines.

  5. The relationship between unilateral mandibular angle fracture and temporomandibular joint function.

    Science.gov (United States)

    Baltrusaityte, Ausra; Surna, Algimantas; Pileicikiene, Gaivile; Kubilius, Ricardas; Gleiznys, Alvydas; Zilinskas, Juozas

    2014-01-01

    PURPOSE. Aim of this study was to analyze relation of occlusal correction and alterations of temporomandibular joint function during treatment of unilateral mandibular fractures. MATERIALS AND METHODS. We compared 49 patients treated for unilateral mandibular fracture without occlusal correction with 21 patient treated for unilateral mandibular fracture along with early and consequent occlusal analysis and correction and with 49 control subjects. Patients' complaints, mandibular movements and occlusal parameters were evaluated during the period of healing. ZEBRIS ultrasound system (Jaw Motion Analyzer, Zebris Medical GmbH, Isny, Germany) was used for analysis of mandibular movements and T-Scan analyzer (Tekscan, Inc., Boston, MA, USA) was used for occlusal analysis. RESULTS. Findings of our study showed statistically significant (p<0.05) diminution of patients complaints, mandibular movement alterations and occlusal disturbances in patients who received occlusal correction during MF treatment if compared to patients treated without occlusal correction, except noises from the joint in the injured side and mandibular lateral track to the injured side in the final stage of investigation. Despite applied treatment recovery of the TMJ function was not complete and the investigated parameters remained worse if compared to the control group. CONCLUSIONS. Results of this study confirmed positive influence of early and subsequent occlusal analysis and correction during stages of MF treatment on diminution of functional alterations of the temporomandibular joint function. Timely occlusal correction improves and hastens process of rehabilitation therefore it is indispensable part of MF treatment.

  6. A computer study of biodegradable plates for internal fixation of mandibular angle fractures

    NARCIS (Netherlands)

    Tams, J; Van Loon, JP; Otten, B; Bos, RRM

    2001-01-01

    Purpose: This computer-based study was performed to determine the suitability of small biodegradable plate systems for mandibular angle fractures. Materials and Methods: In a 3-dimensional computer model of the mandible, fracture mobility and plate strain were calculated for bite forces applied on 1

  7. Surgical Treatment for Occipital Condyle Fracture, C1 Dislocation, and Cerebellar Contusion with Hemorrhage after Blunt Head Trauma

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    Shigeo Ueda

    2016-01-01

    Full Text Available Occipital condyle fractures (OCFs have been treated as rare traumatic injuries, but the number of reported OCFs has gradually increased because of the popularization of computed tomography (CT and magnetic resonance imaging (MRI. The patient in this report presented with OCFs and C1 dislocation, along with traumatic cerebellar hemorrhage, which led to craniovertebral junction instability. This case was also an extremely rare clinical condition in which the patient presented with traumatic lower cranial nerve palsy secondary to OCFs. When the patient was transferred to our hospital, the occipital bone remained defective extensively due to surgical treatment of cerebellar hemorrhage. For this reason, concurrent cranioplasty was performed with resin in order to fix the occipital bone plate strongly. The resin-made occipital bone was used to secure a titanium plate and screws enabled us to perform posterior fusion of the craniovertebral junction. Although the patient wore a halo vest for 3 months after surgery, lower cranial nerve symptoms, including not only neck pain but also paralysis of the throat and larynx, improved postoperatively. No complications were detected during outpatient follow-up, which continued for 5 years postoperatively.

  8. Delayed presentation of fracture of lateral condyle of humerus in pediatric age group treated by ORIF and ulnar peg grafting: A case series

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    Nishikant Kumar

    2015-01-01

    Full Text Available Background: Fractures of lateral condyle of humerus in pediatric age group, the most common being distal humerus epiphyseal injury, are commonly associated with delayed presentation to terminal health care providers. Reasons accounted might be at every level, right from the patient to the physician. In the backdrop of existing disputed treatment strategy operative v/s non-operative treatment of fractures having more than 3-week duration of injury, same were treated by open reduction and k wire fixation using ulnar peg graft. Final functional result was evaluated with longest follow up of over 1 year. Materials and Methods: Twenty children having fracture of lateral condyle of humerus with duration of trauma more than 3 week were included in the prospective study. Age ranged from 5 years to 15 years. Average age was 8 years. Among the 20 patients, 8 were male and 12 were female. Average time of presentation was after 5 weeks of injury. Seven patients had milch type 1 injury and 13 patients had milch type II injury. All patients were treated by open reduction and internal fixation using k wires and ulnar peg graft. The follow-up period was over 1 year. Result: Results were evaluated using radiograph, and functional results were evaluated using the Liverpool elbow scoring system. In the present series, all fractures united with 92% excellent, 5% good, and 3% poor results. Poor results were associated with greater displacement of fracture, prior repeated attempts of close reduction, and history of massage. Conclusion: Being an epiphyseal injury and a common occurrence, fracture of lateral condyle of humerus in pediatric age group are commonly maltreated, with error contributed right from parents to even physician. Common reasons of delayed presentation are ignorance on parents′ side, malpractice by some bone-setters, poorly done radiograph, inaccurate radiographic interpretation by the physician, and poor selection of treatment methods.

  9. Salter-Harris type III fracture of the lateral femoral condyle with a ruptured posterior cruciate ligament: an uncommon injury pattern.

    Science.gov (United States)

    Rafee, Asan; Kumar, A; Shah, S V

    2007-01-01

    We report a case of an obscure injury to the distal femoral epiphysis with an uncommon pattern in a 12-year-old boy following a road traffic accident. Initial plain radiographs of the knee were inconclusive. Further investigation with magnetic resonance imaging revealed Salter-Harris type III fracture of the lateral femoral condyle with a gap at the fracture site associated with avulsion of the posterior cruciate ligament. This potentially serious injury can be underestimated on plain radiographs and therefore any suspected injury to the distal femoral epiphysis should be thoroughly assessed and investigated to institute appropriate treatment and minimise the risk of long-term complications.

  10. Primary osteosynthesis augmented with autologous bone graft with total knee arthroplasty in patients with stress fractures of medial femoral condyle with knee osteoarthritis: a cost effective approach

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    Vikram Indrajit Shah

    2016-06-01

    Results: Mean follow-up was 7.0 years. All patients showed statistically significant improvement in their WOMAC total scores (p <0.05. Stress fractures united with good knee alignment. All patients had recovered full range of motion with no pain at the time of final follow-up. No adverse events were noted in any of the patient treated. Conclusions: The present approach is a successful procedure for the elderly population with an arthritic knee with stress fracture of medial femoral condyle. Return to pre-morbid level of functional activity occurs very swiftly. [Int J Res Med Sci 2016; 4(6.000: 2408-2412

  11. Rapid, conservative, multidisciplinary miniscrew-assisted approach for treatment of mandibular fractures following plane crash

    Directory of Open Access Journals (Sweden)

    Azita Tehranchi

    2013-01-01

    Full Text Available Mandibular fractures are among the most common facial injuries. This case report demonstrates the efficacy of simultaneous usage of miniscrews and direct bonding techniques without open reduction in an extensive traumatized patient. A 25-year-old girl with multiple injuries in the head and facial region 1 month after a plane crash accident was referred to manage the mandibular fractures. Due to the presence of multiple injuries, a conservative treatment of symphysiseal fracture was performed. In order to keep the fractured fragments of the mandible close together, the anterior teeth of the lower arch were tied by means of the orthodontic wire. Ten miniscrews were used to improve the anchorage units and also, settling the occlusion by means of light intermaxillary elastics. Following the active treatment, clinical and radiographic analysis showed satisfactory healing without any periodontal involvement of the teeth in the fracture line.

  12. Eruption status of third molar and its possible influence on the location of mandibular angle fracture: a retrospective analysis.

    Science.gov (United States)

    Kumar, Praveen Satish; Dhupar, Vikas; Akkara, Francis; Kumar, G B Ananth

    2015-06-01

    This study was designed to evaluate the influence of eruption status of mandibular third molars on the location of mandibular angle fracture. We also aimed to evaluate the incidence of damage to mandibular third molar teeth (M3) and its roots. Medical records and panoramic radiographs of 142 patient cohorts with mandibular angle fractures with third molars present were retrospectively reviewed. Revealed that incidence of angle fracture were high in patients with fully erupted M3 when compared to unerupted group. Out of 142 patients, 108 fractures were found involving the M3 socket and 14.1 % had damage to M3. The presence of erupted mandibular third molar increases the chances of angle fracture when compared to impacted M3. Involvement of the M3 socket often resulted in increased operative time and complexity of the surgical procedure with possible removal of the damaged M3.

  13. Alterações dimensionais do côndilo mandibular em indivíduos de 3 a 20 anos de idade usando tomografia computadorizada de feixe cônico: um estudo preliminar Mandibular condyle dimensional changes in subjects from 3 to 20 years of age using Cone-Beam Computed Tomography: a preliminary study

    Directory of Open Access Journals (Sweden)

    José Valladares Neto

    2010-10-01

    Full Text Available INTRODUÇÃO: o exame de tomografia computadorizada de feixe cônico (TCFC oferece excelente representação dos tecidos duros da articulação temporomandibular (ATM. OBJETIVO: investigar as alterações morfológicas do côndilo mandibular, da infância à idade adulta, utilizando a TCFC. MÉTODOS: um estudo transversal foi conduzido envolvendo 36 côndilos de 18 indivíduos com idades variando entre 3 e 20 anos. As imagens dos côndilos foram obtidas por meio do sistema i-CAT e medidas com uma ferramenta do programa específica para ATM, que permite cortes perpendiculares à cabeça do côndilo, com correção individual em função das diferenças angulares de cada um. As maiores distâncias nas vistas lateral e frontal foram consideradas tanto para os côndilos do lado direto como para os do lado esquerdo. RESULTADOS: a dimensão lateral do côndilo mandibular parece ser estabelecida de maneira precoce, sofrendo poucas alterações com o passar dos anos, enquanto a dimensão frontal tende a aumentar. Assimetrias entre o côndilo esquerdo e o direito foram comumente observadas; no entanto, tais diferenças não apresentaram significância estatística para as vistas lateral (P=0,815 e frontal (P=0,374. CONCLUSÕES: os côndilos apresentaram simetria com relação ao tamanho, sendo observado crescimento apenas na dimensão frontal Os resultados sugerem que a TCFC constitui-se numa ferramenta útil na mensuração e avaliação das dimensões condilares.INTRODUCTION: Cone-Beam Computed Tomography (CBCT imaging provides an excellent representation of the temporomandibular joint bone tissues. OBJECTIVE: The aim of this study was to investigate morphological changes of the mandibular condyle from childhood to adulthood using CBCT. METHODS: A cross-sectional study was conducted in 36 condyles of 18 subjects from 3 to 20 years of age. Condyles were scanned with the i-CAT Cone-Beam 3D imaging system and linear dimensions were measured with a

  14. IMF Screw: An Ideal Intermaxillary Fixation Device During Open Reduction of Mandibular Fracture.

    Science.gov (United States)

    Sahoo, N K; Mohan, Ritu

    2010-06-01

    Intermaxillary fixation (IMF) is conventionally used for treatment of fractures involving maxillomandibular complex both for closed reduction and as an adjuvant to open reduction. To overcome the cumbersome procedure of tooth borne appliances cortical bone screws were introduced in the year of 1989 to achieve IMF which is essentially a bone borne appliance. In our institution we treated 45 cases of mandibular fracture both single and multiple fractures by open reduction over a period of 24 months. IMF screws were used to achieve dental occlusion in all the cases. Various advantages, disadvantages and complications are discussed. In our institutional experience we found that the IMF screws are an ideal device for temporary intermaxillary fixation for the cases having only mandibular fracture.

  15. Does the presence or position of lower third molars alter the risk of mandibular angle or condylar fractures?

    Science.gov (United States)

    Naghipur, Saba; Shah, Adnan; Elgazzar, Reda Fouad

    2014-09-01

    The purpose of this study was to determine whether a relation exists between the presence of mandibular third molars (M3s) and mandibular angle and condylar fractures and whether the risk of these fractures varies with M3 position. A retrospective cohort study was conducted in patients with mandibular fractures presenting to the oral and maxillofacial surgery service from April 2007 to March 2012. Data sources were patients' hospital charts and panoramic radiographs. Predictor variables were the presence and position of M3s. M3 position was based on the Pell and Gregory classification and angulation was determined by measuring the angle between the long axis of the M3 and the mandibular occlusal plane. Outcome variables were the presence of angle and condylar fractures. Other study variables included age, gender, and fracture etiology. Data were analyzed using the χ(2) test and Student t test. The study sample consisted of 446 patients with 731 mandibular fractures. Results showed that the risk of mandibular angle fracture was significantly higher in patients and mandible sides with impacted M3s (P .05). The presence of impacted M3s increased the risk of angle fracture and simultaneously decreased the risk of condylar fracture. However, no relation appeared to exist between M3 position and fracture pattern. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Fate of third molar in line of mandibular angle fracture - Retrospective study

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    Preetha Balaji

    2015-01-01

    Conclusion: The present study fails to identify any concrete factors that would predict the failure of the retained third molar that were involved in the line of mandibular fractures. The proof presented here, especially with low complication rates indicate that all impacted third molar along the line of fracture be removed and unless necessary, the partially erupted teeth would also be extracted. In such a situation, the rate of infection and survival of the third molar would have been entirely different.

  17. An analysis of postoperative complications and efficacy of 3-D miniplates in fixation of mandibular fractures

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    Sadhasivam Gokkulakrishnan

    2012-01-01

    Conclusions: It was seen that 3-D titanium miniplates were effective in the treatment of mandibular fractures and overall complication rates were lesser. In symphysis and parasymphysis regions, 3-D plating system uses lesser foreign material than the conventional miniplates using Champy′s principle.

  18. Mandibular symphysis fracture associated with the displacement of a fractured genial segment: An unusual case report with review

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    Krishnaveni Buduru

    2015-01-01

    Full Text Available Fractures and displacement of fragments involving the genial tubercles due to trauma are rarely seen in patients with a full complement of teeth although spontaneous fractures of the genial tubercles in edentulous atrophic mandible are not uncommon. These are usually displaced and may be missed during routine clinical and radiographic examinations owing to superimposition of the features of a fractured mandible. Very few cases have been reported till date. Their implications lie in functional alterations that occur as a consequence of loss of attachment of the geniohyoid and genioglossus muscles. There is no universal opinion on the treatment of fractures involving the genial tubercles. Possible treatments include no surgical intervention, excision of the avulsed bone fragments, and muscular repositioning. We present a case of mandibular fracture associated with the fracture and displacement of a fragment involving the genial tubercles in a dentate patient where in the finding was incidental and a review of literature.

  19. Role of fixation in posttraumatic nerve injury recovery in displaced mandibular angle fracture

    Science.gov (United States)

    Singh, R. K.; Pal, U. S.; Singh, Pranshu; Singh, Geeta

    2016-01-01

    Objective: The objective of this study was to assess the effectiveness of different types of fixation in the enhancement of posttraumatic inferior alveolar nerve (IAN) recovery in displaced mandibular angle fracture and to establish. Patients and Methods: Thirty patients of displaced mandibular angle fracture were treated with preangulated plate and three-dimensional (3D) matrix plate in two groups and were observed during follow-up at 04,06 and 12 weeks along with other parameters. Results: Fifteen patients were treated with preangulated plate and 15 patients with 3D matrix miniplate. There was early nerve recovery in Group A than Group B, with residual paresthesia 20% in Group A and 26.6% in Group B at the end of 12-week follow-up. Conclusion: The displaced mandibular angle fracture with posttraumatic IAN paresthesia treated with preangulated plate has shown evidence of early nerve recovery than those fractures were treated with matrix miniplate. The fracture fragments displaced more than 9 mm have shown poor nerve recovery in both groups. PMID:28163475

  20. Modified Risdon approach using periangular incision in surgical treatment of subcondylar mandibular fractures

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    Nikolić Živorad S.

    2016-01-01

    Full Text Available Introduction. No consensus has been reached yet on the surgical approach for treatment of condylar fractures. Objective. The aim of this study was to present modified Risdon approach (without facial nerve identification in the treatment of subcondylar mandibular fractures. Method. This is a retrospective study of a period 2005-2012. During this seven-year period, 25 condylar mandibular fractures in 22 men and three women (19-68 years old were treated by modified Risdon approach without identifying the facial nerve. The main inclusion criterion was subcondylar fracture according to Lindahl classification. Results. No additional morbidity related to postoperative complications, such as infection or salivary fistula, was observed in this series. Only two (8% patients developed temporary weakness of the marginal branch of the facial nerve, which resolved six weeks postoperatively. Each patient achieved good mouth opening postoperatively. Scar was camouflaged in the first cervical wrinkle. Two patients developed temporomandibular joint dysfunction. No patient had postoperative occlusal disturbance. In all of the patients good aesthetic result was achieved in a two-year follow-up. Conclusion. In comparison with techniques described in the literature, the main advantages of the modified Risdon approach are the following: no need for facial vessels identification; direct, fast, and safe approach to mandibular angle and subcondylar region; relatively simple surgical technique and good cosmetic result - due to aesthetically placed incision. This approach could be recommended for subcondylar fracture as a simplified and safe procedure. [Projekat Ministarstva nauke Republike Srbije, br. 175075

  1. Characteristics and Distribution of Mandibular Fractures Due to External Causes: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Dmitry José de Santana SARMENTO

    2007-05-01

    Full Text Available Purpose: To investigate the characteristics and distribution of the cases of mandibular fractures due to external causes treated at the Hospital Regional de Campina Grande, PB, Brazil, between January 2002 and December 2006. Method: For such purpose, an indirect review of 691 medical-hospital patient files of the Service of Oral and Maxillofacial Surgery were reviewed. A total of 59 (8.5% files referred to mandibular fracture victims. The following variables were analyzed: gender, age range, time of occurrence (date and hour, etiology, presence of associated fractures, type of treatment and time of hospitalization. Results: The results showed that males were more frequently affected than females (83.1%, with predominance in the 21-30 age range (40.7%. Most cases were treated on Saturdays and Sundays (40.6% and at night (30.5%. Falls, (28.8%, interpersonal violence (23.7% and motorcycle accidents (23.7% were the main etiologies. Five patients (8.5% presented fractures in other facial bones and the most frequent treatment was the intermaxillary retention with stainless steel wire (50.8%. The mean hospitalization time was 5.28 days.Conclusions: The prevalence of mandibular fractures is higher in the male gender, during the third decade of life; falls were the main etiologic factor and most cases occurred during the weekend.

  2. Forces that fracture teeth during extraction with mandibular premolar and maxillary incisor forceps.

    Science.gov (United States)

    Ahel, V; Ćabov, T; Špalj, S; Perić, B; Jelušić, D; Dmitrašinović, M

    2015-12-01

    Our aim was to measure the forces that fracture teeth during extraction based on the effectiveness of the extraction forceps, and to compare them with data collected about forces applied to extracted teeth that did not fracture. We studied 208 patients whose teeth fractured during both the standard and our new method of extraction: maxillary incisors (n=79) extracted with forceps 1 (maxillary incisor forceps), and both maxillary (n=95) and mandibular incisors (n=34) extracted with forceps 13 (mandibular premolar forceps). Forces needed to fracture were assessed with a specially-designed instrument for measuring pressure and rotation. Mean (SD) pressure at the fracture site was significantly higher in maxillary incisors extracted with forceps 1 (1.26 (0.26) bar) then in both maxillary and mandibular incisors extracted with forceps 13 (0.96 (0.19) and 0.98 (0.16), pforces that break teeth during extractions are sometimes only slightly higher than the extraction forces, so caution is needed during extraction.

  3. Fate of developing tooth buds located in relation to mandibular fractures in three infancy cases.

    Science.gov (United States)

    Yamamoto, Kazuhiko; Matsusue, Yumiko; Murakami, Kazuhiro; Horita, Satoshi; Matsubara, Yuri; Kuraki, Miho; Kurihara, Miyako; Imai, Yuichiro; Sugiura, Tsutomu; Kirita, Tadaaki

    2010-08-01

    The fate of developing tooth buds located in relation to mandibular fractures was investigated in three infancy cases. Three infants, 2 girls and a boy, aged from 1 year and 5-months old to 2 years and 6-months old, were treated for dislocated mandibular fracture in the symphyseal region by manual reduction and fixation with a thermoforming splint and circumferential wiring under general anesthesia. Fracture healing was uneventful in all cases. A few years later, no obvious deformity of the jaw or malocclusion was observed; however, malformation of the crown was found in one of the permanent teeth on the fracture line in the first case. In the second case, no abnormality was observed in one of the permanent teeth on the fracture line, but the effect on the other tooth could not be evaluated due to abnormality of the tooth probably not related to the injury. In the third case, root formation was arrested in one of the permanent teeth on the fracture line and the tooth was lost early after eruption. The development of tooth buds on the fracture line is not predictable and therefore, should be monitored by regular follow up.

  4. Experimental study on healing process of rat mandibular bone fracture examined by radiological procedures

    Energy Technology Data Exchange (ETDEWEB)

    Iuchi, Yukio; Furumoto, Keiichi (Nippon Dental Univ., Tokyo (Japan))

    1994-06-01

    The healing process of rat mandibular fractures was stereoscopically observed daily, using plain roentgenography in the lateral-oblique and tooth axis directions and bone scintigraphy using 99m-Tc-methylene diphosphoric acid (Tc-99m-MDP). The findings were compared with microradiograms of regional polished specimens. X-ray findings included the following. Up to 3 days after bone fracture, the fracture mesiodistally showed distinct radiolucency, with sharp and irregular fracture stump. Radiopacity of the fracture site gradually increased 7 days or later, and bone trabecular formation by callus and stump bridging started to occur at 14 days. Findings similar to those in the control group were observed 49 days or later. The inside was difficult to differentiate, irrespective of the observation time. Bone scans in the mesiodistal and buccolingual planes revealed tracer uptake in the areas of mandibular and soft tissue damage one day after bone fracture. Tracer uptake began to be seen in the fracture site 3 days later, and became marked at 14 days. Then Tc-99m DMP began to be localized and returned to the findings similar to those at 49 days. Bone scanning tended to show wider areas earlier than roentgenography. Microradiographic mesiodistal examination revealed distinct radiopacy of the fracture line for 3 days after bone fracture. Seven days later, bone resorption cavity occurred in the cortical bone around the fracture stump, along with neogenesis of callus. Neogenesis and calcification began to occur gradually, and 14 days later, the fracture osteoremodeling of the internal bone trabeculae was observed. Bone trabecular formation within the bone, however, occurred later. (N.K.).

  5. Assessment of humeral length in dogs after repair of Salter-Harris type IV fracture of the lateral part of the humeral condyle.

    Science.gov (United States)

    Lefebvre, Jean-Benoit G N G; Robertson, Thomas R A; Baines, Stephen J; Jeffery, Nicholas D; Langley-Hobbs, Sorrel J

    2008-08-01

    To evaluate the effect of fracture and subsequent repair on future bone growth of the humerus after Salter-Harris type IV fracture of the lateral part of the humeral condyle (LPHC). Prospective study. Dogs (n=11). Dogs that had LPHC fracture and an open distal humeral physis repaired (1992-2006) were re-examined and radiographed at >or=12 months of age and humeral length was measured. Measurements from 11 dogs showed a significant (P=.02) increase in length of the humeral diaphysis of the affected leg compared with that of the intact limb (median, 1.2%; range, 1.3-3.4%). Condylar deformity secondary to growth disturbance was not observed. Shortening or growth deformity was not observed after fracture and repair even if a transcondylar screw was placed through the distal humeral growth plate. A mild overgrowth of the humeral diaphysis was observed, although likely considered clinically unimportant. Fracture of the LPHC and subsequent repair in dogs >3 months of age do not impair growth of the humeral diaphysis. A transcondylar humeral screw placed through the humeral physis will not result in shortening of the humeral diaphysis. Implant removal to allow for further growth is therefore not indicated.

  6. Management of Mandibular Fracture in a Peripheral Health Setting ...

    African Journals Online (AJOL)

    Hp 630 Dual Core

    the dentate mandible, reduction must aim to restore good functional ... precise reduction may be acceptable if sections of the body of the mandible are edentulous or ... Appearance of the patient after healing of fracture occurred intra orally.

  7. A comparative study between transbuccal and extra-oral approaches in treatment of mandibular fractures.

    Science.gov (United States)

    Kale, Tejraj P; Baliga, S D; Ahuja, Nitin; Kotrashetti, S M

    2010-03-01

    Mandibular angle fractures continue to be a common type of facial injury. The objectives in treatment are to effect rapid healing by anatomic reduction and fixation and to restore function and appearance with minimal disability and complications. Traditionally, when open techniques are utilised, the extra-oral approach is performed through a skin incision concealed in the submandibular crease. However, patients develop unsightly scars and there is a risk of injury to the marginal mandibular nerve. In comparison, the trans-oral approach, performed through an oral mucosal incision, results in minimal external scarring or injury to the marginal mandibular nerve and allows direct visualisation and confirmation of the desired occlusion during the placement of the miniplates. The basic aim of the study was to provide a treatment for the mandibular fractures which results in minimal scarring and fulfills all the functional needs of the patient. Patients coming to KLES PK Hospital and MRC with mandibular angle fractures requiring open reduction and internal fixation admitted under OMFS were taken for the study. The sample size of the study was 15. In one group, the patients were treated by extra-oral approach and the other group by transbuccal approach. In patients treated by transbuccal approach, special armamentarium consisting of trocar, cannula, and cheek retractor were used; and in both the groups, semirigid fixation was done using two miniplates with around a distance of 1cm. Total of 15 patients were treated, 10 with transbuccal approach and 5 with submandibular approach. It has been found that both techniques fulfill the functional requirements of the patients. Patients treated with submandibular approach developed obvious unsightly scars, whereas transbuccal approach results in minimal scarring. The results associated with clinical observations suggest that transbuccal approach is a superior and less time consuming approach than extraoral approach, but it requires

  8. SD大鼠单侧髁突颈横行截骨、骨折致下颌骨偏斜的研究%Study on mandibular deviation caused by unilateral condylar neck osteotomy and fracture in SD rats

    Institute of Scientific and Technical Information of China (English)

    朱房勇; 陈玉华; 李国民; 邹建明; 李松

    2013-01-01

    目的 建立年轻SD大鼠单侧髁突颈部截骨、骨折的动物模型,探讨应力改变明显致大鼠下颌骨髁突生长发育受到影响时,下颌骨偏斜程度的变化.方法 72只雄性SD大鼠按完全随机法分3组,每组24只,建立大鼠单侧髁突颈部横行截骨、骨折的动物模型,观察截骨组、骨折组、对照组术后1、3、5、9周下颌骨偏斜程度的变化.结果 截骨组、骨折组术后在4个时间点下颌骨均向手术侧偏斜,α值均小于对照组,差异有统计学意义(P<0.05),截骨组与骨折组之间差异无统计学意义(P>0.05).截骨组手术侧术后1周髁突区膨大,大量增生的软组织包裹.术后3周髁突头呈缩小趋势,术后5、9周髁突变窄而高.骨折组手术侧术后1周髁突呈圆柱状,见骨折线.术后3、5、9周,髁突圆柱状呈缩小趋势,但缩小程度不如截骨组手术侧.结论 单侧髁突颈截骨相对骨折,影响下颌骨及髁突生长发育,但两组的下颌骨偏斜程度无影响.%Objective To establish unilateral condylar neck osteotomy and fracture in SD rats model,and discuss the effect of significant stress changes on the growth and development of mandible in SD rats.Methods Seventy-two SD rats were randomly divided into 3 groups,24 for each group,including unilateral condylar process osteotomy group,fracture group,un-operated blank control group.The changes of asymmetric mandibular were observed 1,3,5,9 weeks after operation.Results The mandibular of osteotomy group and fracture group deflected on the operation side in the four times,and the α value was small than control one,with significant difference(P<0.05).But the mandibular of osteotomy group was not different from fracture group(P>0.05).In osteotomy group,the growth and development of condyle in osteotomy side was enlargement after 1 week,enclosed with proliferation of soft tissues,and became shrinkage after 3 weeks,narrower and higher after 5,9 weeks.While in fracture

  9. Temporomandibular disorders due to improper surgical treatment of mandibular fracture: clinical report.

    Science.gov (United States)

    Mortellaro, Carmen; Rimondini, Lia; Farronato, Giampietro; Garagiola, Umberto; Varcellino, Vittorio; Berrone, Mattia

    2006-03-01

    A case of mandibular fracture surgically consolidated in a wrong position resulting in craniomandibular disorders is reported. The inadequate surgical alignment of the healed bony segments caused a malocclusion. This changed the original neuromuscular system such that compensatory mechanisms began to change the whole balance of the organism. The patient presented a mandibular crossbite, an asymmetry of the face, and extensive alteration of muscular, articular, and postural function. The bony malunion and malocclusion were treated using an interdisciplinary surgical-orthodontic treatment for correcting functional disorders and aesthetic deformity. Electromyography and computerized mandibular scanning were used to evaluate improvement of the muscular activity, during rest and function, and of the mandibular kinesiology. Timing of surgical treatment and adequate fixation and immobilization of fracture segments are very important to avoid complications such as infection, delayed union, nonunion, malunion, skeletal discrepancies, nerve injury, and (rarely) ankylosis. The surgical approach should be based on the general criteria of traumatologic therapy, restoring the original bone shape and the right occlusal relations as soon as possible.

  10. Collagenases and gelatinases in bone healing. The focus on mandibular fractures

    Directory of Open Access Journals (Sweden)

    Kurzepa Jacek

    2014-06-01

    Full Text Available Due to high amount of collagen fibres in the structure of bone, the enzymes capable of collagen digestion play a key role in bone remodelling. Matrix metalloproteinases (MMPs, prevailing extracellular endopeptideses, can digest extracellularly located proteins, e.g. collagen, proteoglycans, elastin or fibronectin. Among MMPs, collagenases (MMP-1, MMP-8 and MMP-13 and gelatinases (MMP-2 and MMP-9 can cleave collagen particles to forms that are able to undergo further steps of catabolism intracellularly. In addition, activity of the gelatinases (as an activation of proinflammatory cytokines facilitates spreading inflammation that is necessary during the first stage of bone healing. Further studies related to the role of various MMPs in mandibular fractures should precisely explain their function in the bone healing and evaluate the influence of MMPs inhibitors on that process. This review provides the basic information about two groups among MMPs family, collagenases and gelatinases, and their role in repairing processes after mandibular fractures.

  11. [Use of adaptogens for antioxidant system correction in complex treatment of mandibular fractures].

    Science.gov (United States)

    Ushnitsky, I D; Terenteva, Z V; Kerschengoltz, B M; Vinocurov, M M; Voronov, I V; Egorova, L I

    2015-01-01

    Antioxidatic protection has been studied in 84 patients with mandibular fractures between the ages of 21 and 40; the patients were divided into two groups. Activation of lipid peroxidation in both groups was revealed. The increase of antioxidant's activity system in 37.18% in the main study group that along with traditional treatment received Epsorin was determined. No complications in the main group during the post-surgery period were recorded.

  12. In vitro fracture resistance of mandibular incisors restored with modified partial-coverage ceramic restorations.

    Science.gov (United States)

    Vilaplana-Vivo, Jaime; Vilaplana-Vivo, Carlos; Miguel-Sánchez, Alfonso; García-Ballesta, Carlos; Camacho-Alonso, Fabio

    2014-10-01

    The aim of this in vitro study was to investigate the impact fracture resistance of anterior teeth that had been fractured and restored with modified partial-coverage ceramics using the edge-up technique. A total of 178 extracted human mandibular central and lateral incisors were included in this study. The incisors were randomly divided into two groups. Group 1 (n = 89) teeth were cleaved and restored with modified partial-coverage ceramics using the edge-up technique; Group 2 (n = 89) consisted of intact teeth that served as control. Impact strength was tested in a modified impact testing machine (pendulum type), and the severity of crown fracture after fracture resistance test was registered. Impact strength was insignificantly lower in restored teeth (median 5.39 and range 0.81-14.12 kJ m(-2) ) than in intact teeth (median 5.45 and range 0.31-16.47 kJ m(-2) ), although no statistically significant differences were observed. Regarding the severity of crown fracture, restored teeth showed a lower rate of severe fractures (20.22%) compared to intact teeth (25.84%), but no statistically significant differences were observed. Restoration of cleaved mandibular incisors with modified partial-coverage ceramics using the edge-up technique shows fracture resistance and severity of crown fracture following traumatism similar to intact teeth. In this way, this technique can be used successfully for the treatment of fractured anterior teeth. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. The role of 3D plating system in mandibular fractures: A prospective study

    Directory of Open Access Journals (Sweden)

    Rajendra Prasad

    2013-01-01

    Full Text Available Aim: The aim of our study was to evaluate the advantages and disadvantages of 3D plating system in the treatment of mandibular fractures. Patients and Methods: 20 mandibular fractures in 18 patients at various anatomic locations and were treated by open reduction and internal fixation using 3D plates. All patients were followed at regular intervals of 4 th , 8 th and 12 th weeks respectively. Patients were assessed post-operatively for lingual splay and occlusal stability. The incidence of neurosensory deficit, infection, masticatory difficulty, non-union, malunion was also assessed. Results: A significant reduction in lingual splay (72.2% and occlusal stability (72.2% was seen. The overall complication rate was (16.6% which included two patients who developed post-operative paresthesia of lip, three patients had infection and two cases of masticatory difficulty which later subsided by higher antibiotics and 4 weeks of MMF. No evidence of non-union, malunion was noted. Conclusion: A single 3D 2 mm miniplate with 2 mm × 8 mm screws is a reliable and an effective treatment modality for mandibular fracture.

  14. Transoral versus extraoral approach for mandibular angle fractures: A comparative study

    Directory of Open Access Journals (Sweden)

    Sathya Kumar Devireddy

    2014-01-01

    Full Text Available Introduction: Mandibular fractures represent approximately two-thirds of all the maxillofacial fractures (nearly 70% out of which fractures of mandibular angle represent for 26-35%. Aim of the Study: The aim of this study is to compare the transoral and extraoral (submandibular approaches for fixation of mandibular angle fractures. Objectives of Study: The objectives of the following study are to evaluate ease of accessibility, time taken for the procedure, ease of anatomic reduction and complications. Materials and Methods: A prospective study was carried out in 30 patients reporting to the Department of Oral and Maxillofacial surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh during the period of months from November 2011 to August 2013 who were randomly divided in two groups based on computer generated simple randomization chart. Group I patients underwent transoral reduction and fixation and Group II patients underwent extraoral reduction and fixation. The ease of accessibility was analysed by visual analogue scale by the operating surgeon, time taken from incision to closure with digital clock, difficulty level index of surgeon based on the time taken for the procedure and approach related complications. Results: The ease of accessibility in Group I was good in 53.3% while in Group II patients approached extraorally it was good in 86.7%. Group I patients approached transorally showed a mean of 49.7 min while that of Group II patients approached extraorally showed a mean of 73.4 min. Group I had a minimum difficulty level index in 60%, moderate difficulty level in 33.3% and severe difficulty level in 6.7% while Group II had a minimum and moderate difficulty level in 46.7% and severe difficulty level in 6.7%. There was 1 (6.7% complication reported in each group. Conclusion: The statistical analysis of this study concludes that fracture line starting anterior to mandibular third molar and ending at anteroinferior border of

  15. Evaluation of Three Different Osteosynthesis Methods for Mandibular Angle Fractures

    DEFF Research Database (Denmark)

    Pereira-Filho, Valfrido Antonio; Oliveira, Luis Fernando de Gorla; Reis, José Maurício Dos Santos Nunes;

    2016-01-01

    The aim of this study was to evaluate the mechanical behavior of different rigid fixation methods in mandible angle fractures. Three different plates were tested: one 4-hole grid miniplate, one 8-hole curved grid miniplate, and one 4-hole straight miniplate.For the loading tests, 30 polyurethane ...

  16. Fractures of the mandibular coronoid process: a two centres study

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Roccia, F.; Gallesio, C.; Forouzanfar, T.

    2014-01-01

    The aim of this study was to assess the characteristics of patients with coronoid fractures treated in two European centres over 10 years and to briefly review the literature. This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with m

  17. MR imaging of the temporomandibular joint in patient with acute mandibular condylar fracture

    Energy Technology Data Exchange (ETDEWEB)

    Park, Il Soon; Na, Jae Boem; Kang, Su Jin; Kim, Jae Hyoung; You, Jin Jong; Lee, Sang Hwy; Kim, Il Hyun [Gyeongsang National Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To analyze various MR imaging findings and thus evaluate the usefulness of MR imaging of the temporomandibular joint in patient with acute mandibular condylar fracture. MR imaging was performed within 1 week after trauma in 25 patients (total joints studied = 31) in whom condylar fracture had been diagnosed by simple radiographs. We analyzed the signal intensity of bone marrow and disk, displacement of bone fragment and disk, deformity. In addition, MRI findings of retrodiskal tissue, joint capsule and joint effusion were evaluated. No abnormal signal intensity was noted in bone marrow or disk. Displacement of a condylar fracture fragment was observed in 24 joints(77 %) (anteromedial, 63 %; medial, 25 %; anterior, 4 %; anterolateral, 4 %; and lateral, 4 %). Disk displacement occurred in 23 joints(74 %) (anteromedial, 65 %; medial, 9 %; anterior, 18 %; anterolateral, 4 %; and lateral, 4%). In 17 joints (55 %) the disk was displaced along with the fractured condylar fragment, and disk deformity was noted in five joints(16 %). MR imaging (T2WI) revealed a capsular tear(n=1), joint effusion(n=26), and high signal intensity in the retrodiskal tissue(n=6). MR imaging provided information concerning condylar fragments, disk, retrodiskal tissue, capsules, and joint effusion. In patients with acute mandibular condylar fracture, MRI is therefore useful for evaluation of the temporomandibular joint.

  18. Are Biodegradable Plates Applicable in Endoscope-Assisted Open Reduction and Internal Fixation of Mandibular Subcondyle Fractures?

    Science.gov (United States)

    Son, Jang-Ho; Ha, Jinhee; Cho, Yeong-Cheol; Sung, Iel-Yong

    2017-08-01

    To investigate whether biodegradable plates are applicable in endoscope-assisted open reduction and internal fixation (EAORIF) of mandibular subcondyle fractures. This retrospective case-series study included patients with mandibular subcondyle fractures treated with EAORIF using an unsintered hydroxyapatite particles/poly-l-lactide biodegradable plate system, with at least 6 months of clinical follow-up data available. The outcome variables were fracture healing with postoperative stability and postoperative complications. Other variables included age, gender, fracture site, cause of injury, accompanying mandibular fracture, total follow-up period, fracture classification, extent of displacement, preoperative status of occlusion, preoperative mandibular movements, fixation materials in accompanying mandibular fracture, location and number of fixation plates, periods of intermaxillary fixation/elastic bands, and postoperative mandibular movements. Fracture healing in these patients was assessed by comparing the immediate postoperative cone-beam computed tomography (CBCT) images with those obtained at least 3 months after surgery. A total of 11 patients, 9 male and 2 female, with a mean ± standard deviation age of 35.3 ± 15.9 years, were included. The mean follow-up period was 18.8 ± 7.8 months. Four patients had an accompanying mandibular fracture. Two 4-hole, 2.0-mm biodegradable plates were fixed with 6-mm screws along the posterior border of the mandibular ramus and near the sigmoid notch. Complete bone formation around the fracture lines or fading of the fracture lines, with no change in the position of the fractured segments, was observed on the postoperative CBCT images at 3 months. With the exception of 2 patients, no patient complained of plate palpability, deviation in occlusion, or discomfort during the postoperative follow-up period. EAORIF using biodegradable plates for mandible subcondylar fractures is a stable and reliable method, with

  19. Fractures of Medial Condyle of Humerus in Children:a Report of 16 Cases%小儿肱骨内髁骨折

    Institute of Scientific and Technical Information of China (English)

    许伦祥

    1991-01-01

    报告1974~1986年经手术切开复位内固定治疗小儿肱骨内髁骨折16例,Fowles分型Ⅲ型14例,Ⅱ型2例.新鲜骨折采用肘内侧纵行切口,陈旧性骨折用肘后纵行切口.术后用长臂石膏托固定4周.16例中,除因手术处理不当致肘功能障碍2例,尺神经损伤和骨化性肌炎各1例以外,其余12例功能恢复良好.%From 1974 to 1986,16 cases of fractures of medial condyle of humerus were treated with open reduction and internal fixation.The medial cubital longitudinal incision was applied to the fresh fracture and posterior cubital incision to the old fracture.All cases were immobilized with plaster splint for 4 weeks.Of them,2 cases complicated with elbow joint dysfunction,one ossfying myositis and one ulnar nerre damage.The others have recovered.

  20. Evaluation of postoperative complications according to treatment of third molars in mandibular angle fracture

    Science.gov (United States)

    2017-01-01

    Objectives The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture. PMID:28280708

  1. Experimental studies of healing process of rat mandibular condylar fracture, using /sup 45/Ca as tracer

    Energy Technology Data Exchange (ETDEWEB)

    Shimizu, Tatsuaki (Gifu Univ. (Japan). Faculty of Medicine)

    1982-09-01

    The cervical region of the mandibular condylus of young rats was fractured. The healing process was observed pathohistologically, autoradiographically using /sup 45/Ca as a tracer, and by ultra soft roentgenography. Condylectomy of the mandibular condylus was done at the same time and its regeneration observed. The results of the observation are as follows: The fractured portion is bonded with the soft tissue 1 - 2 weeks postoperatively. Histologically, new-blood vessels in the granulation tissue and the connective tissue's change into fibers are seen. On the second week chondrocytes appeared in the neck of the capitulum mandibulae and the stump of the ascending branch. On the 3rd postoperative week, the stump of the fracture of the bone is bonded with proliferated cartilaginous tissue and an osseous bond was seen in part by autoradiograph and ultra soft x-ray picture. New bone due to periosteal ossification is seen around the stump on the ascending branch side, and the bone reconstruction with osteoclasts was seen in the inside the trabeculae. On the 4th postoperative week, osseous concrescence is observed in the fractured portion. Regeneration of the capitulum mandibulae after extirpation of the capitulum mandibulae is seen in all the cases. On the postoperative 12th week, the macroscopic form of the degenerated capitulum mandibulae which seemed to be excessive becomes almost the same morphologically with that of the contralateral side and it was observed histologically that the construction of the capitulum mandibulae is completely restored.

  2. Does an Association Exist Between the Presence of Lower Third Molar and Mandibular Angle Fractures?: A Meta-Analysis.

    Science.gov (United States)

    Ruela, Wagner de Sousa; de Almeida, Vinícius Lima; Lima-Rivera, Luciana Monti; Santos, Pâmela Letícia; Porporatti, André Luís; de Freitas, Paulo Henrique Luiz; Paranhos, Luiz Renato

    2017-06-13

    The current data suggest that the presence of lower third molars predisposes the patient to a greater risk of mandibular angle fracture. Thus, the present review sought to determine whether an association exists between the presence of a lower third molar and the occurrence of a mandibular angle fracture in adults and to assess the influence of third molar position according to the Pell and Gregory classification. The present study was a systematic review and meta-analysis of analytical observational studies. The present review included all reports of the relationship between mandibular angle fractures and lower third molars. No restriction regarding year, language, or publication status was used. The review protocol was registered at the PROSPERO database (registration no. CRD42016047057). Electronic searches unrestricted for publication period and language were performed in the PubMed, Scopus, SciELO, and Latin American and Caribbean Health Sciences databases. Google Scholar and OpenGrey databases were used to search the "gray literature," avoiding selection and publication biases. The entire search was performed by 2 eligibility reviewers. Association and proportion meta-analyses were planned for the studies with sufficient data. The primary predictor variable was the relationship between the presence of a lower third molar and the development of mandibular angle fractures. The secondary outcome variables were the vertical and horizontal positions of the lower third molar, according to the Pell and Gregory classification and their relationship to the susceptibility to developing a mandibular angle fracture. The search strategies resulted in 411 studies, from which 16 were selected for qualitative and quantitative review. The association meta-analysis included all the selected studies and showed that patients with lower third molars are 3.16 times more likely to develop mandibular angle fractures. The proportion meta-analysis included 5 studies and showed that

  3. Factores relevantes en complicaciones de fracturas mandibulares: Relato de 5 años Factors relevant to mandibular fracture complications: A 5-year experience

    Directory of Open Access Journals (Sweden)

    E. Serena Gómez

    2009-04-01

    Full Text Available Objetivo: Este estudio ayudará a comprender factores relevantes y su relación con complicaciones post-operatorias en pacientes con tratamiento de fracturas mandibulares. Diseño de estudio: Para el estudio fueron obtenidos datos de pacientes atendidos en un periodo de cinco años por el Área de Cirugía y Traumatología Buco-Maxilofacial de la Facultad de Odontología de Piracicaba, UNICAMP, Brasil. Los datos relevantes de los pacientes en esta investigación fueron; edad, género, actividad económica, consumo de sustancias, etiología del trauma, demora de tratamiento de fractura, tipo de fractura mandibular, complicación post-operatoria y tratamiento a la complicación. Resultados: Un total de 472 pacientes presentaron fracturas mandibulares, de los cuales 54 pacientes (11,4% desarrollaron alguna complicación postoperatoria al tratamiento. En el grupo de pacientes con complicaciones postoperatorias, el género masculino predominó con 44 pacientes y la media de edad fue de 29,3 años de edad. En este grupo se presentaron sin actividad económica 35,2% de los pacientes y 33 (61% relataron abuso en sustancias nocivas a la salud. La agresión física fue la causa mas común (35,1%. Fracturas mandibulares múltiples fueron relatadas en 34 pacientes (62,9%. Infección se presento en 32 pacientes (59,2%. Tratamiento hospitalario para las complicaciones fue necesario para 30 pacientes (55,5%. Conclusiones: Actividad económica y demora en el tratamiento de fracturas mandibulares no fueron significantes en el desarrollo de complicaciones post-operatorias. Por otra parte, la severidad del trauma y el tipo de fractura, consideradamente pueden influir, así como el consumo de sustancias, que presentó una fuerte relación en la presencia de complicaciones.Objective: This study was made to determine the factors relevant to postoperative complications in patients treated for mandibular fracture. Study design: The study was based on the medical

  4. Mandibular fracture wounded by a projectile of a firearm

    Directory of Open Access Journals (Sweden)

    Juan Carlos Quintana Díaz

    2015-08-01

    Full Text Available A case of a male Yemenite 20 year-old-patient from Ibb city that was attended by a team of interdisciplinary Cuban professors at the Hospital of Al Waheda belonging to Thamar University, who received a maxillofacial wounded by a projectile of a firearm, which caused him great destruction of the tissues of the jawbone region is presented. A reduction and fixing of the fracture was performed with excellent esthetical and functional results. In this work, it is set out how the life of this patient was saved and the maxillofacial wound was reconstructed, thanks to the arduous work of the Cuban professors that gave the patient back to the society alive, with an excellent esthetical and functional rehabilitation, demonstrating one more time the humanitarian work of the Cuban medicine in other countries. 

  5. Distraction Osteogenesis Correction of Mandibular Ramis Fracture Malunion in a Juvenile Mute Swan ( Cygnus olor ).

    Science.gov (United States)

    Calvo Carrasco, Daniel; Dutton, Thomas A G; Shimizu, Naomi; Sabater, Mikel; Forbes, Neil A

    2016-03-01

    A juvenile mute swan (Cygnus olor) was presented with right lateral deviation of the mandible. Radiographs demonstrated a healed fracture of the right mandibular ramis, which had compromised osteogenesis. A corrective osteotomy was performed and an osteogenic distractor was inserted over the lateral aspect of the right mandible. Dental acrylic implants were fixed to the rhinotheca to correct rotational alignment. A pharyngostomy tube was placed to facilitate administration of nutrition and medication. Postoperative images confirmed correct alignment of the mandible in relation to the maxilla. Implants were removed and postoperative complications were not reported. This is the first report of an osteogenic distractor used to correct mandibular deviation in an avian species. Distraction osteogenesis should be considered as a valid surgical option in juvenile or adult avian patients with pathologic bone shortening.

  6. Open Reduction and Internal Fixation of Mandibular Fracture without Rigid Maxillomandibular Fixation

    Directory of Open Access Journals (Sweden)

    El-Anwar, Mohammad Waheed

    2015-03-01

    Full Text Available Introduction The ability to treat fracture with open reduction and internal fixation (OR/IF has dramatically revolutionized the approach to mandible fracture. With OR/IF, the postoperative role of rigid maxillomandibular fixation (MMF has declined, but it is used to maintain proper occlusion until internal fixation of the fracture is achieved. Objective To assess intraoperative manual MMF during OR/IF of selected cases of mandibular fractures. Methods This prospective study was conducted on 80 patients with isolated mandibular fractures managed by OR/IF using two titanium miniplates. The patients were classified into two groups: a control group (40 patients treated by OR/IF after intraoperative rigid MMF followed by immediate MMF removal, and a study group (40 patients treated by rigid MMF, which was replaced by temporary intraoperative manual MMF (3MF until plate fixation. Results There were no significant differences of the postoperative complication and dental occlusion, although a highly significant reduction of operative time was achieved in the 3MF group. Patient who received the 3MF technique had statistically significantly better average intrinsic vertical mouth opening in the early postoperative period (1 week after surgery, and normal mouth opening could be achieved in all cases in both groups 8 weeks after surgery. Conclusions Intraoperative rigid MMF is not mandatory and can be replaced in selected cases of fracture mandible by manual maintenance of proper dental occlusion until hardware fixation, gaining the advantages of shorter operative time and less risk of blood-transmitted diseases to the surgical team and the patient in addition to the benefits of immediate postoperative mandible mobilization.

  7. Qualitative and quantitative assessment of relationship between mandibular third molar and angle fracture on North Indian population: A clinico-radiographic study.

    Science.gov (United States)

    Yadav, Suresh; Tyagi, Shallu; Puri, Naveen; Kumar, Prince; Kumar, Puneet

    2013-04-01

    To assess the relationship between impacted mandibular third molar presence and the risk for mandibular angle fracture with the effect of various positions of mandibular third molar and the risk of mandibular angle fracture. In the North Indian territory, a total of 289 patients with mandibular angle fractures were studied and evaluated for the possible relationship with impacted third molar on the basis of clinical and panoramic radiographical findings. Results that confirmed the highest risk for mandibular angle fracture was associated with mesioangular angulations (45.42%) followed by vertical (26.34%), distoangular in sequence and least risk was found with bucco-version angulations (2.67%) according to Winter's classification. Additionally, the highest risk of mandibular angle fracture was reported with partially erupted third molar (47.75%), followed by erupted (23.53%) and unerupted third molar (19.38%). The risk for mandibular angle fracture is not only affected by status of eruption, angulations, position, number of roots present in third molar but also by the distance of mandibular third molar from inferior border of mandible and the percentage of remaining amount of bone at the mandibular angle region.

  8. Tratamiento conservador de las fracturas del cóndilo: Evaluación radiológica y clínica Conservative treatment of condyle fractures: Radiological and clinical evaluation

    Directory of Open Access Journals (Sweden)

    A. Wassouf

    2005-04-01

    de apertura de la boca de 30 a 60 mm. Para concluir, el tratamiento conservador de las fracturas del proceso condilar es un método de tratamiento seguro que evita la cirugía y produce fiablemente buenos resultados. El grado de desplazamiento o de acortamiento de la rama ascendente no precluyó obtener buenos resultados en este estudio.Benefits of surgical treatment for condylar fractures are to date discussed controversially in the literature. As conservative treatment is the method of choice in our clinic, the purpose of this study is to evaluate the outcomes of a randomised selected group of our patients who received conservative treatment for condylar fractures. The acts of 30 patients (18 males, 12 females, mean age of 25 years treatment for condylar fractures between 1997 and 2000 with a mean follow up time of 12 months have been assessed. A total of 35 condyle fractures were included in this study. The treatment applied was maxillo-mandibular fixation (MMF for 2 weeks on unilateral fractures, and 3 - 4 weeks on bilateral fractures. Initial radiological evaluation of the broken condyles angulations and shortening of the ascending ramus was performed. Clinical and radiological examinations were assessed in regular intervals (6 weeks, 3, 6 and 12 months. 5 patients presented bilateral fractures; all of them had anterior dislocation. In the unilateral fracture group 12 presented anterior dislocations (mean value of 23° on the panoramic x-ray. 13 cases presented posterior dislocation (mean value of 10°. On the (PA projections 12 fractures presented medial dislocation (mean value of 14°, 4 presented lateral dislocation (mean value of 6°. Ascending ramus shortening reached a mean value of 5.40 mm. Satisfactory function and mobility were observed in all the treated cases. Posttraumatic sequels as TMJ clicking (5 of 29, deviation by mouth opening (14 of 27, reduction of lateral movements and protrusion (in 15 of 29 and finally mouth opening ranged 30 to 60 mm. In

  9. Effects of recombinant human basic fibroblast growth factor on cell proliferation during mandibular fracture healing in rabbits

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the effects of recombinant human basicfibroblast growth factor (rhbFGF) on the cell proliferation during mandibular fracture healing in rabbits.Methods: The complex of rhbFGF and bovine type I collagen was implanted into the mandibular fracture site under periosteum of the animal. The whole mandible was harvested at 7, 14, 28, 56 and 84 days respectively after operation. The expression of proliferating cell nuclear antigen (PCNA) in callus was examined with immunohistochemical staining.Results: PCNA-positive cells in callus in the rhbFGF-treated group on days 7 and 14 were more than that in the control group (P<0.01).Conclusions: It indicates that rhbFGF can stimulate cell proliferation during mandibular fracture healing in rabbits.

  10. Rigid internal fixation with titanium versus bioresorbable miniplates in the repair of mandibular fractures in rabbits.

    Science.gov (United States)

    Hochuli-Vieira, E; Cabrini Gabrielli, M A; Pereira-Filho, V A; Gabrielli, M F R; Padilha, J G

    2005-03-01

    The purpose of this study was to compare by qualitative histology the efficacy of rigid internal fixation with titanium system and the Lacto Sorb system in mandibular fractures in rabbits. Thirty male adult rabbits Oryctolagus cuniculus were used. Unilateral mandibular osteotomies were performed between the canine and first premolar. The animals were divided into two groups: for Group I-rigid internal fixation was performed with titanium system 1.5 mm (Synthes, Oberdorf, Switzerland), with two screws of 6 mm (bicortical) on each side of the osteotomy. For Group II-rigid internal fixation was performed with PLLA/PGA system 1.5 mm (Lacto Sorb, WLorenz, Jacksonville, FL, USA). The histological analysis evaluated the presence of inflammatory reaction, degree of bone healing and degree of resorption of the Lacto Sorb screws. The results of both fixation systems were similar, only with a small difference after 15 and 30 days. In Group I a faster bony healing was noted. But after 60 days, bony healing was similar in both groups. It is concluded that both PLLA/PGA and titanium plates and screws provide sufficient strength to permit mandibular bone healing. The resorption process of PLLA/PGA osteosynthesis material did not cause acute or chronic inflammatory reaction or foreign body reaction during the studied period.

  11. Radiographic and computed tomography monitoring of a fractured needle fragment in the mandibular branch

    Energy Technology Data Exchange (ETDEWEB)

    De Oliveira e Britto Villalobos, Maria Isabel; Leite, Thaisa Cristina Gomes Ferreira; Barra, Samila Goncalves; Da Cunha Werneche, Daniela Teresa Pinto; Manzi, Flavio Ricardo; E Alves Cardoso, Claudia Assuncao [Dept. of Dentistry, Pontificial Catholic University of Minas Gerais, Belo Horizonte (Brazil)

    2017-03-15

    Some complications can arise with the usage of local anesthesia for dental procedures, including the fracture of needles in the patient. This is a rare incident, usually caused by the patient's sudden movements during anesthetic block. Its complications are not common, but can include pain, trismus, inflammation in the region, difficulty in swallowing, and migration of the object, which is the least common but has the ability to cause more serious damage to the patient. This report describes a case in which, after the fracture of the anesthetic needle used during alveolar nerve block for exodontia of the left mandibular third molar, the fragment moved significantly in the first 2 months, before stabilizing after the third month of radiographic monitoring.

  12. Radiographic and computed tomography monitoring of a fractured needle fragment in the mandibular branch

    Science.gov (United States)

    Leite, Thaisa Cristina Gomes Ferreira; Barra, Samila Gonçalves; Werneche, Daniela Teresa Pinto da Cunha; Manzi, Flavio Ricardo; Cardoso, Claudia Assunção e Alves

    2017-01-01

    Some complications can arise with the usage of local anesthesia for dental procedures, including the fracture of needles in the patient. This is a rare incident, usually caused by the patient's sudden movements during anesthetic block. Its complications are not common, but can include pain, trismus, inflammation in the region, difficulty in swallowing, and migration of the object, which is the least common but has the ability to cause more serious damage to the patient. This report describes a case in which, after the fracture of the anesthetic needle used during alveolar nerve block for exodontia of the left mandibular third molar, the fragment moved significantly in the first 2 months, before stabilizing after the third month of radiographic monitoring. PMID:28361032

  13. Use of Orthodontic Mini-Implants for Maxillomandibular Fixation in Mandibular Fracture

    Science.gov (United States)

    Pires, Mario Sergio Medeiros; Reinhardt, Leandro Calcagno; Antonello, Guilherme de Marco; Torres do Couto, Ricardo

    2011-01-01

    Orthodontic appliances for skeletal anchorage are becoming increasingly more common in clinical practice. Similarly, different terms such as mini-implants, microimplants, and miniscrews have been used. There is a wide array of appliances currently on the market, in different designs and sizes, diameters, degree of titanium purity, and surface treatment. These appliances have been used for a variety of indications, including tooth retraction, intrusion, and traction. This study aimed to report the clinical case of a 19-year-old patient with a fractured mandible and to propose a novel use of mini-implants: the perioperative placement of mini-implants as anchors for maxillomandibular fixation steel wire ligatures. We concluded that this appliance provides an effective maxillomandibular fixation in patients with mandibular fracture, with little increase in the cost of surgery. PMID:23205173

  14. Radiographic and computed tomography monitoring of a fractured needle fragment in the mandibular branch.

    Science.gov (United States)

    Villalobos, Maria Isabel de Oliveira E Britto; Leite, Thaisa Cristina Gomes Ferreira; Barra, Samila Gonçalves; Werneche, Daniela Teresa Pinto da Cunha; Manzi, Flavio Ricardo; Cardoso, Claudia Assunção E Alves

    2017-03-01

    Some complications can arise with the usage of local anesthesia for dental procedures, including the fracture of needles in the patient. This is a rare incident, usually caused by the patient's sudden movements during anesthetic block. Its complications are not common, but can include pain, trismus, inflammation in the region, difficulty in swallowing, and migration of the object, which is the least common but has the ability to cause more serious damage to the patient. This report describes a case in which, after the fracture of the anesthetic needle used during alveolar nerve block for exodontia of the left mandibular third molar, the fragment moved significantly in the first 2 months, before stabilizing after the third month of radiographic monitoring.

  15. Characterization of an injectable, degradable polymer for mechanical stabilization of mandibular fractures.

    Science.gov (United States)

    Henslee, Allan M; Yoon, Diana M; Lu, Benjamin Y; Yu, Joseph; Arango, Andrew A; Marruffo, Liann P; Seng, Luke; Anver, Tamir D; Ather, Hunaiza; Nair, Manitha B; Piper, Sean O; Demian, Nagi; Wong, Mark E K; Kasper, F Kurtis; Mikos, Antonios G

    2015-04-01

    This study investigated the use of injectable poly(propylene fumarate) (PPF) formulations for mandibular fracture stabilization applications. A full factorial design with main effects analysis was employed to evaluate the effects of the PPF:N-vinyl pyrrolidone (NVP, crosslinking agent) ratio and dimethyl toluidine (DMT, accelerator) concentration on key physicochemical properties including setting time, maximum temperature, mechanical properties, sol fraction, and swelling ratio. Additionally, the effects of formulation crosslinking time on the mechanical and swelling properties were investigated. The results showed that increasing the PPF:NVP ratio from 3:1 to 4:1 or decreasing the DMT concentration from 0.05 to 0.01 v/w % significantly decreased all mechanical properties as well as significantly increased the sol fraction and swelling ratio. Also, increasing the crosslinking time at 37°C from 1 to 7 days significantly increased all mechanical properties and decreased both the sol fraction and swelling ratio. This study further showed that the flexural stiffness of ex vivo stabilized rabbit mandibles increased from 1.7 ± 0.3 N/mm with a traditional mini-plate fixator to 14.5 ± 4.1 N/mm for the 4:1 (0.05 v/w % DMT) PPF formulation at day 1. Overall, the formulations tested in this study were found to have properties suitable for potential further consideration in mandibular fracture fixation applications. © 2014 Wiley Periodicals, Inc.

  16. [Mandibular collum fracture in the ultrasound image--indications and limits from the viewpoint of 3 years imaging experiences].

    Science.gov (United States)

    Volkenstein, R; Friedrich, R; Vesper, M; Gehrke, G

    1996-01-01

    The Ultrasound technique as an image producing procedure for fractures of the mandibular collum is outlined with physical theory and clinical examples. Advantages and disadvantages are compared and it is stated that a part of all patients with fractures might have a benefit from this method. Mentally handicapped patients, pregnant women and all sorts of fidgety patients will profit by the ultrasound investigation as the only way to ascertain the bone-fracture. There is necessity to relate the sonogram to a conventional X-ray picture whenever it is possible, for the procedure is suited to prove the fracture, not to exclude it.

  17. Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature

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    Sohrab Keyhani

    2015-04-01

    Not inserting multiple guide pins, keeping a safe distance from the posterior cortex and giving more attention during graft tensioning, especially in revision surgeries, are all small points that can reduce the risk of fracture during the revision of ACL reconstruction

  18. Non-IMF mandibular fracture reduction techniques: A review of the literature.

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    Batbayar, Enkh-Orchlon; van Minnen, Baucke; Bos, Ruud R M

    2017-08-01

    Intermaxillary fixation (IMF) techniques are commonly used in mandibular fracture treatment to reduce bone fragments and re-establish normal occlusion. However, non-IMF reduction techniques such as repositioning forceps may be preferable due to their quick yet adequate reduction. The purpose of this paper is to assess which non-IMF reduction techniques and reduction forceps are available for fracture reduction in the mandible. A systematic search was performed in the databases of Pubmed and EMBASE. The search was updated until February 2016 and no initial date and language preference was set. 14 articles were selected for this review, among them ten articles related to reduction forceps and four articles describing other techniques. Thus, modification and design of reduction forceps and other reduction techniques are qualitatively described. Few designs of repositioning forceps have been proposed in the literature. Quick and adequate reduction of fractures seems possible with non-IMF techniques resulting in anatomic repositioning and shorter operation time, especially in cases with good interfragmentary stability. Further development and clinical testing of reduction forceps is necessary to establish their future role in maxillofacial fracture treatment. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  19. Postoperative infection associated with mandibular angle fracture treatment in the presence of teeth on the fracture line: a systematic review and meta-analysis.

    Science.gov (United States)

    Bobrowski, A N; Sonego, C L; Chagas Junior, O L

    2013-09-01

    The aim of this review was to answer the question: Which is the best procedure to follow when there is tooth involvement in the line of mandibular angle fracture, taking into consideration the occurrence of postoperative infection? A systematic literature review using the PubMed (MEDLINE), Virtual Health Library (VHL), Cochrane Library, and Scopus databases was done, and a total of 1007 articles were found. Among these, 13 articles were included in the final review after the papers were read. A series of 1542 mandibular angle fractures with the presence of teeth in the fracture line was obtained. Of 788 cases where the tooth was removed, a postoperative infection occurred in 84 cases; of 754 cases where the tooth was retained, postoperative infection also occurred in 84 cases. Through this review it was observed that there was no significant statistical difference between removing or retaining the tooth in the line of fracture and the occurrence of postoperative infection.

  20. Fractura mandibular patológica por plasmocitoma intraóseo Pathological mandibular fracture due to intraosseous plasmacytoma

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    D. Antunes Freitas

    2012-06-01

    duct and rarely in the oral cavity. The search for a systemic disease is important in cases where the diagnosis is made. A case of a patient, a man of 73 years of age, residing in the rural village of Great Mogol, Minas Gerais (Brazil, Computed tomography showed irregular osteolytic hypodensity and resorption at the base of the left mandibular alveolar ridge. The lesion measuring 38.0 mm × 19.0 mm × 15.0 mm. On CT clearly shows the presence of pathological fracture of the left side. Needle aspiration was performed, where blood was obtained. Incisional biopsy was performed. The presumptive diagnosis was ameloblastoma. The biopsy specimen was sent for analysis anatomohistopatológica. Microscopy showed tumor cells composed of monomorphic cells with oval nuclei, large peripheral and eccentric, prominent nucleoli and basophilic cytoplasm, surrounded by scant stroma and infiltration of cancellous bone. The urine test was conducted specifically for the Bence-Jones protein, which was negative. The skull and chest radiographs were performed and showed no changes. He then completed a diagnosis of solitary plasmacytoma of the jaw. The patient is undergoing radiotherapy at the Oncology Department of Santa Casa de Misericordia. The patient had severe mucositis and changes in facial color as a result of radiotherapy.

  1. Infection rate in mandibular angle fractures treated with a 2.0-mm 8-hole curved strut plate.

    Science.gov (United States)

    Bui, Peter; Demian, Nagi; Beetar, Patrick

    2009-04-01

    The aim of this study was to determine the rate of postoperative infection and the efficacy of removing teeth in the line of mandibular angle fractures treated with 2.0-mm 8-hole titanium curved strut plates. Our understanding is that this method of repair is currently being used only in a few centers in the United States. A retrospective review of mandibular angle fractures treated with a 2.0-mm 8-hole strut plate during a 4-year period. Postoperative antibiotics were given for 1 week. Follow-up appointments were 4 weeks or longer. A nonchewing diet was instructed for 6 weeks. Data for all selected patients include the information such as age, gender, etiology of injuries, medical history, concurrent injuries, nerve deficits, pre- and postoperative antibiotic administration, postop infection, a presence or absence of teeth in the line of fractures, and whether these teeth were removed. Four patients (4 of 49 or 8.2%) developed infections. Two of those patients had a tooth in the line of a fracture that was retained (2 of 14 or 14%). The third had a tooth in the line of a fracture that was extracted (1 of 18 or 5.6%). The fourth patient was 1 of the 17 patients who did not have teeth in the line of fracture and developed infection (1 of 17 or 5.9%). None of the patients developed failed hardware, malunion, nonunion, malocclusion, or iatrogenic nerve injury. The use of a 2.0-mm 8-hole strut plate is associated with a low infection rate (8.2%). The infection rate for those mandibular angle fractures with teeth in the line of fracture retained was 14% compared with 5.6% for those fractures with the teeth in the line of fracture extracted.

  2. Leonard buttons: a reliable method of intraoperative intermaxillary fixation in bilateral mandibular fractures.

    Science.gov (United States)

    Ghazali, Naseem; Benlidayi, M Emre; Abizadeh, Neilufer; Bentley, Robert P

    2012-05-01

    To retrospectively audit outcomes of using Leonard buttons (LBs) as intraoperative intermaxillary fixation in conjunction with open reduction-internal fixation of bilateral mandibular fractures. Seventy-seven patients were included in this study. The fracture reduction score was obtained from postoperative radiographs by use of 3-tiered scoring system. Medical case notes were obtained for clinicodemographic data, including operation length, postoperative occlusion scores, periodontal status, and complications. The cohort predominantly comprised male patients (87%), with a mean age of 26 years. The major cause of injury was interpersonal violence (87%). The fracture pattern most treated was angle-parasymphysis fracture (70.1%). The mean length of follow-up was 83.81 ± 79.33 days. The mean overall reduction score was 6.95 ± 1.03 in the LB group and 6.40 ± 1.68 in the arch bar (AB) group (P = .275). When the occlusion scores were evaluated, the difference between the 2 groups was statistically significant (P = .027). The mean operation length was shorter in the LB group compared with the AB group (142.05 ± 32.31 minutes vs 161.00 ± 24.04 minutes, P = .013). Oral hygiene was poor in 7 patients in the LB group (11.3%) and in 5 patients in the AB group (33.3%) (P = .05). No significant correlation was observed between number of LBs placed with overall reduction and occlusion scores. No significant relation was observed for number of LBs and periodontal status, infection, and nonunion. This pilot study suggests that LBs are able to achieve equally good reduction as ABs but have better occlusion scores, with a shorter operating time, and show better gingival health. LBs are a viable alternative to ABs in providing intraoperative intermaxillary fixation for bilateral mandibular fractures. However, further prospective, randomized studies should be undertaken to obtain conclusive evidence. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons

  3. Routine removal of the plate after surgical treatment for mandibular angle fracture with a third molar in relation to the fracture line

    Science.gov (United States)

    Yamamoto, Kazuhiko; Matsusue, Yumiko; Horita, Satoshi; Murakami, Kazuhiro; Sugiura, Tsutomu; Kirita, Tadaaki

    2015-01-01

    Purpose: The purpose was to analyze the clinical course of surgically treated mandibular angle fractures from the viewpoint of routine removal of the plate because these fractures are associated with high rates of complications and plate removal. Subjects and Methods: The subjects were 40 patients with unilateral mandibular angle fracture, which was intraorally reduced and principally fixed with a single miniplate on the external oblique ridge. The third molar in relation to the fracture line was extracted in seven patients during the surgery. Clinical course was evaluated in terms of removal of the plate, preservation of the third molar and complications. Results: One patient showed a wound infection postoperatively, and two patients developed pericoronitis during the follow-up. These were managed with medication and local irrigation. One patient with a preserved third molar did not make a required visit and was lost from the follow-up. Removal of the plates was performed in 39 patients after confirmation of good fracture healing, mostly within a year. Twenty-four of 32 preserved third molars were simultaneously extracted. These procedures were generally performed under local anesthesia on an outpatient basis, and they did not cause any complications. Conclusions: Routine removal of the plate after surgical treatment for mandibular angle fractures, simultaneously with extraction of the third molar if indicated, may be beneficial to avoid complications related to the plate and the third molar later in life. PMID:26389039

  4. [Immediate and long-term results of surgical treatment of patients for traumatic mandibular fracture].

    Science.gov (United States)

    Kopchak, A V

    2014-01-01

    The analysis of immediate and long-term results of the surgical treatment of 286 patients, operated for traumatic mandibular fractures in the Department of Oral and Maxillofacial Surgery, National O. O. Bogomolets Medical University. In 67% of patients the anatomical shape of the bone was adequately restored. The presence of residual displacements in other cases was determined by the fracture type and localization, the technical complexity of the surgical intervention, lack of fixation rigidity under certain functional load conditions. In long terms of observation the infection and inflammatory complications were observed in 13.4% of patients, delayed unition and non-unition of bone fragments occurred--in 4.7%, arthosis with persistent dysfunction of the temporomandibular joint--in 6.7%, fibrous ankylosis--in 1.3%. Secondary displacement of fragments was observed in 23.5% of patients due to insufficient stiffness and reliaability of the bone-fixatorsystem. The non-precise reposition of fragments and secondary displacements in the early and late postoperative period were the main cause of occlusal disturbances of various severities, noted in 28% of operated patients, limitation of mouth opening (10%), TMJ disorders and changes in masticatory stereotype (33%), the sensation of pain and discomfort in tough food chewing (35%). A statistical analysis of the effectiveness of different osteosynthesis methods depending on the type and localization of the fracture was carried out and recommendations for usage of fixation devices in clinical practice were given.

  5. Osteosíntesis intraoral asistida por endoscopia en las fracturas del proceso condilar de la mandíbula: revisión de 53 casos Endoscopically assisted intraoral osteosynthesis in mandibular condylar process fractures: a review of 53 cases

    Directory of Open Access Journals (Sweden)

    Carlos Cristobal Goizueta-Adame

    2012-12-01

    Full Text Available Objetivos: La reducción anatómica con fijación rígida de la fractura extracapsular del cóndilo de la mandíbula es esencial para asegurar la correcta función articular. El abordaje intraoral ha demostrado ser una vía segura y de escasa morbilidad. Los autores revisan una serie de 53 pacientes con fracturas extracapsulares de cóndilo mandibular tratados mediante reducción abierta y fijación interna rígida a través de un acceso exclusivamente intraoral asistido por endoscopia. Material y métodos: El objetivo de la cirugía fue la reducción anatómica y la fijación interna mediante osteosíntesis rígida a través de una incisión intraoral. Se realizó una revisión de los casos intervenidos entre 2007 y 2011. Resultados: Treinta y cinco fracturas subcondíleas y 20 fracturas de cuello de cóndilo fueron intervenidas por este método. Un 55% de las fracturas presentaron una o más fracturas asociadas. A partir del control postoperatorio con ortopantomografía, se constató la corrección o mejoría del alineamiento de los fragmentos en 51 fracturas (92%. En 37 pacientes (69,8% se evitó la fijación intermaxilar. En estos pacientes se recuperó la apertura oral a las 5 semanas y media de la cirugía. En el resto, el plazo fue de casi 9 semanas de media tras la retirada del bloqueo. Cinco pacientes presentaron alteraciones oclusales, mientras que una paciente presentó limitación de apertura oral. Conclusiones: La reducción abierta con fijación interna rígida de las fracturas extracapsulares de cóndilo mandibular mediante abordaje intraoral asistido por endoscopia es un tratamiento eficaz, seguro y reproducible.Objectives: The anatomic reduction with rigid fixation of an extracapsular mandibular condyle fracture is essential to ensure that the joint functions correctly. The intraoral approach has been shown to be safe and with a low morbidity. The authors review a series of 53 patients with extracapsular mandibular condyle

  6. A Method for Direct Fabrication of a Lingual Splint for Management of Pediatric Mandibular Fractures

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    Gerardo P. Romeo, DDS, MD

    2013-10-01

    Full Text Available Summary: Pediatric mandibular fractures have successfully been managed in various ways. The use of a lingual splint is one such option. The typical indirect method for acrylic lingual splint fabrication involves obtaining dental impressions. Dental models are produced from those impressions so that model surgery may be performed. The splint is then made on those models using resin powder and liquid monomer in a wet laboratory and transferred to the patient. Obvious limitations to this technique exist for both patient and operator. We present a technique for direct, intraoperative, fabrication of a splint using commercially available light-cured material that avoids some of the shortcomings of the indirect method. Recommendations are made based on available material safety information.

  7. THE CONDITION OF PERIODONTAL TISSUES IN PATIENTS WITH MANDIBULAR FRACTURES IN COMBINATION WITH INFLAMMATORY DISEASES OF PERIODONTIUM IN DYNAMICS OF TREATMENT

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    H.U. Bisultanov

    2008-03-01

    Full Text Available The immobilization of broken fragments by two-jaw anchor splints in patients with the mandibular fractures in a combination with inflammatory diseases ofperiodontium usually causes the exacerbation and progression of the diseases and growing progressively worsening ofperiodontium status. The intensity of these conditions depends on an initial status ofperiodontal tissue. The posttraumatic suppurative inflammatory complications of the mandibular fractures frequency depending on the initial stage of periodontal disease are marked.

  8. The use of Portland cement in the repair of mandibular fractures in rats Uso de cimento Portland no reparo de fratura mandibular em ratos

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    Reginaldo Inojosa Carneiro Campello

    2011-12-01

    Full Text Available PURPOSE: To evaluate the bone healing of mandibular fractures following the use of Portland cement. METHODS: Thirty-two male Wistar rats were divided into control and experimental groups. In the control group the rats were submitted to a mandibular fracture, which was reduced, and the soft tissues were sutured. In the experimental group the rats had the mandibular fracture reduced and maintained with the Portland cement. The animals were euthanized 7 and 21 days after surgery by injecting a lethal dose of anesthetic. The following variables were studied: weight of the animals, radiographic images, histopathological features and time of surgery. RESULTS: A weight loss was observed in the specimens of both groups at the different times of evaluation, a greater difference in weight before and after surgery being found in the experimental group, which was statistically significant (p OBJETIVO: Avaliar a reparação óssea de fratura mandibular após o uso do cimento Portland (CP. MÉTODOS: Trinta e dois ratos machos Wistar foram divididos em grupo controle e grupo experimental. No grupo controle os ratos foram submetidos à fratura, redução e manutenção dos seguimentos com sutura dos tecidos moles. No grupo experimental foram submetidos a fratura, redução e manutenção dos segmentos fraturados com CP e sutura dos tecidos. Os animais foram eutanasiados com sete e 21 dias de pós-operatório através da injeção de dose letal dos anestésicos adotados. As variáveis estudadas foram: peso dos animais, avaliação tomográfica, avaliação histológica e tempo cirúrgico. RESULTADOS: Perda de peso foi observada nos espécimes de ambos os grupos nos diferentes intervalos de tempo considerados, sendo maior a diferença de peso antes e após cirurgia para o grupo experimental, que foi estatisticamente significante (p<0,05; p=0,041. Do ponto de vista histológico para a margem de erro fixada (5,0% as duas únicas diferenças significativas (p<0

  9. Antimicrobial prophylaxis in open reduction and internal fixation of compound mandibular fractures: a collaborative regional audit of outcome.

    Science.gov (United States)

    Singh, Rabindra P; Carter, Lachlan M; Whitfield, Paul H

    2013-07-01

    We conducted a regional 2-stage prospective audit involving 5 different maxillofacial units in the Yorkshire region of the UK to evaluate the effectiveness of perioperative antimicrobial prophylaxis in the treatment of mandibular fractures. In the first stage (145 patients) we surveyed current practice concerning antimicrobial prophylaxis and found out the current infection rate after open reduction and internal fixation (ORIF) of mandibular fractures. In the second stage (157 patients) we implemented a common antimicrobial protocol in all units and recorded the infection rates using the new regimen. In the first stage a wide range of antimicrobial prophylaxis was used in different units. The agreed perioperative antimicrobial protocol in the second stage was to begin amoxicillin or clarithromycin and metronidazole intravenously on admission and include 2 postoperative doses. The infection rates were 10.3% and 8.9%, respectively, and the difference between the two groups was not significant (χ(2)=0.051, df=1, p=0.83). The infection rate in the Yorkshire region was similar to results from other centres. We recommend short perioperative antimicrobial prophylaxis with a maximum of 2 postoperative doses after ORIF of mandibular fractures.

  10. The retromandibular transparotid approach for reduction and rigid internal fixation using two locking miniplates in mandibular condylar neck fractures.

    Science.gov (United States)

    Kanno, T; Sukegawa, S; Tatsumi, H; Nariai, Y; Ishibashi, H; Furuki, Y; Sekine, J

    2014-02-01

    We evaluated the safety, efficacy, and morbidity associated with the treatment of displaced mandibular condylar neck fractures using a retromandibular transparotid approach to reduce and rigidly fix using two 2.0-mm locking miniplates. Our surgical inclusion criteria were: patient selection of open reduction and fixation, displaced unilateral condylar fractures with derangement of occlusion, and bilateral condylar fractures with an anterior open bite. The study group consisted of 19 patients who underwent surgery for 19 mandibular condylar neck fractures; patients were analyzed prospectively, with more than 6 months of follow-up, and were evaluated in terms of functional results, scar formation, postoperative complications, and stability of fixation. The results showed that functional occlusion identical to the preoperative condition and correct anatomical reduction of the condylar segments in centric occlusion, followed by immediate functional recovery, was achieved in all patients. No patient suffered from any major or permanent complication postoperatively, although there were two cases (11%) of temporary facial nerve palsy, which resolved completely within 3 months. Surgical scars were barely visible. The retromandibular transparotid approach with open reduction and rigid internal fixation for displaced condylar neck fractures of the mandible is a feasible and safe, minimally invasive surgical technique that provides reliable clinical results.

  11. Performance in different types of chondrocytes in mandibular condylar fractures%软骨细胞在不同类型下颌骨髁状突骨折中的表现

    Institute of Scientific and Technical Information of China (English)

    姚志涛; 努尔比亚·艾比布拉; 王玲; 买买提吐逊·吐尔地

    2016-01-01

    Objective To investigate the different types of mandibular condylar fractures effects on chondrocytes performance.Methods 3-month-old sheep were caused by mandibular condylar longitudinal and transverse fracture,respectively,after one week,three weeks,six weeks the rats were sacrificed by cervical dislocation,condylar cartilage in both groups mandibular condylar fracture and the control group were detected by immunofluorescence proliferating cell nuclear antigen (PCNA) positive cells in order to understand the different types of mandibular condylar fracture cell The proliferation,apoptosis using TdT-mediated dUTP nick end labeling (TUNEL) stain to understand the situation of different types of mandibular condylar fracture of cartilage cells,in order to understand the different types of mandibular condylar fracture of the bone after a relationship between the processes within the condylar cartilage.Results There was a significant difference,postoperative 1 week two fracture types of proliferating cell nuclear antigen (PCNA) in contrast,transverse fracture group (group A) 42.31%,vertical type group (group B) 91.30%,control group (Group C) 95.74%.Postoperative 3 weeks,6 weeks of condylar process of longitudinal and transverse fracture of PCNA in two groups of 51.61% in group A,48.57%,group B 82.93%,63.16%,group C 93.02%,75.00%.TUNEL results for 1 week after operation in group were 66.67%,91.30%,77.27%,postoperative 3 weeks and 6 weeks group A was 69.77%,69.36%,B group was 86.67%,91.49%,group C was 77.27%,81.25%,articular condyle longitudinal fracture of apoptotic cells higher than the transverse fracture,and cell proliferation is lower than the number of transverse fracture type;decreasing the expression of postoperative one week,three weeks,six weeks are two types of fractures of the condylar cartilage into bone each marker,cartilage fall within the osteogenic capability,longitudinal fracture more obvious markers to reduce the two

  12. Mistaken Endobronchial Placement of a Nasogastric Tube During Mandibular Fracture Surgery.

    Science.gov (United States)

    Kalava, Arun; Clark, Kirpal; McIntyre, John; Yarmush, Joel M; Lizardo, Teresita

    2015-01-01

    A 64-year-old male had an awake right nasal fiber-optic intubation with an endotracheal tube for open reduction and internal fixation of bilateral displaced mandibular fractures. After induction of anesthesia, an 18 Fr nasogastric tube (NGT) was inserted through the left nostril and was secured. The patient required high flow rates to deliver adequate tidal volumes with the ventilator. A chest x-ray done in the postanesthesia care unit revealed a malpositioned NGT in the left lower lobe bronchus, which was immediately removed. The patient was extubated on postoperative day 2. Various traditional methods, such as aspiration of gastric contents, auscultation of gastric insufflations, and chest x-ray are in use to detect or prevent the misplacement of an NGT. These methods can be unreliable or impractical. Use of capnography to detect an improperly placed NGT should be considered in the operating room as a simple, cost-effective method with high sensitivity to prevent possibly serious sequelae of an NGT placed within the bronchial tree.

  13. Fratura de côndilo occipital associada a fratura de Jefferson e lesão dos nervos cranianos caudais: relato de caso Occipital condyle fracture associated with Jefferson's fracture and injury of lower cranial nerves: case report

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    Asdrubal Falavigna

    2002-12-01

    Full Text Available A fratura de côndilo occipital (FCO é patologia que pode passar despercebida à avaliação médica, não só por sua infrequência (1% como pela variedade de diagnóstico clínico e dificuldade na visualização dessa área ao exame radiológico de rotina. Essa fratura pode vir associada a lesões de nervos cranianos (31%, sendo o hipoglosso o mais comumente envolvido (67%. É rara sua associação com fratura de Jefferson. Relatamos o caso de uma paciente de 58 anos, que desenvolveu FCO, lesão de nervos cranianos caudais e fratura de Jefferson após uma queda. O tratamento preconizado foi tração cervical por seis semanas seguida pelo uso de halo-colete por três meses. Houve consolidação óssea e regressão da lesão nervosa. O objetivo deste relato é alertar para que, uma vez diagnosticada a FCO, está indicada investigação radiológica da transição crânio-cervical pela possibilidade da presença de lesões simultâneas nervosas, de nervos cranianos e ósseas, como por exemplo a fratura de Jefferson. Apesar de suas associações serem raras, devem ter seu diagnóstico conhecido para poder ser manejadas adequadamente.Occipital condyle fracture(OCF is rarely seen and can be missed during medical evaluation due to the variety of clinical presentations and the difficulty to be visualized radiographically. This fracture can be associated with cranial nerves injuries (31%, being the hipoglossal nerve the most frequently involved (67%. We report a 58 years old female patient who presented with OCF, injury of lower cranial nerves and Jefferson's fracture. The patient was treated with cervical traction for six weeks followed by halo immobilization for three months. There was bone consolidation recovery of the nervous injury after this period. This report emphazises the importance of investigating the skull-cervical transition in all patients with cervical trauma. Although Jefferson's fracture is rarely associated with OCF, it should be

  14. Analysis of surgical curative effect of complex Tibial plateau fracture involved with poster condyle%手术治疗累及后髁的复杂性胫骨平台骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    邓和胜

    2013-01-01

    Objective To explore the clinical surgical effect of the treatment of complex tibial plateau fracture involved with poster condyle. Methods 31 cases with complex tibial plateau fractures involved with poster condyle were treated with open reduction and internal fixation from October 2005 to October 2011. The outcomes were graded into the excellent, the good, the fair and the poor basing on the Wang Yi-cong’s criteria of the knee function post-operatively. Results A11 the patients had been followed up averag 12.4±2.6 months(ranged from 6 to 22). The healing time was 6~11 weeks with an average of 6.4±1.6 weeks. Out of the 35 cases, The knee function were excellent in 16 cases, good in 12 cases, fair in 2 cases and poor in 1 cases. The rate of the excellent and the good was 90.32% basing on the Wang Yi-cong’s criteria of the knee function post-operatively. Conclusion The clinical surgical effect of the treatment of complex tibial plateau fracture involved with poster condyle are satisfactory.%目的探讨手术治疗累及后髁的复杂性胫骨平台骨折的临床疗效。方法2005年10月~2011年10月,对31例累及后髁的复杂性胫骨平台骨折行切开复位内固定。结果应用王亦璁膝关节功能评定标准,分为优、良、可、差四级。结果本组31例均获得随访,时间6~22个月,平均12.4±2.6个月,骨折全部愈合,愈合时间6~11周,平均6.4±1.6周。依王亦璁膝关节功能评定标准,优16例,良12例,可2例,差1例,优良率为90.32%。结论手术入路治疗累及后髁的复杂性胫骨平台骨折疗效令人满意。

  15. A comparison of the fracture resistances of endodontically treated mandibular premolars restored with endocrowns and glass fiber post-core retained conventional crowns

    Science.gov (United States)

    Guo, Jing; Wang, Zhiming; Li, Xuesheng; Sun, Chaoyang; Gao, Erdong

    2016-01-01

    PURPOSE This in-vitro study aimed to evaluate the fracture resistances and failure modes of endodontically treated mandibular premolars restored with endocrowns and conventional post-core retained crowns. MATERIALS AND METHODS Thirty mandibular premolars were assigned into three groups (n=10): GI, intact teeth; GE, teeth with endocrowns; GC, teeth with conventional post-core supported crowns. Except for the teeth in group GI, all specimens were cut to 1.5 mm above the cementoenamel junction and endodontically treated. Both endocrowns and conventional crowns were fabricated from lithium-disilicate blocks using a CEREC 3D CAD/CAM unit. All specimens were subjected to thermocycling and then to 45° oblique compressive load until fracture occurred. The fracture resistance and failure mode of each specimen were recorded. Data were analyzed with one-way ANOVA and LSD Post Hoc Test (α=.05). RESULTS The fracture resistances of GE and GC were significantly lower than that of GI (P<.01), while no significant difference was found between GE and GC (P=.702). As of the failure mode, most of the specimens in GE and GC were unfavorable while a higher occurrence of favorable failure mode was presented in GI. CONCLUSION For the restoration of mandibular premolar, endocrown shows no advantage in fracture resistance when compared with the conventional method. Both of the two methods cannot rehabilitate endodontically treated teeth with the same fracture resistances that intact mandibular premolars have. PMID:28018567

  16. A Comparative Assessment of Postoperative Analgesic Efficacy of Lornoxicam versus Tramadol after Open Reduction and Internal Fixation of Mandibular Fractures.

    Science.gov (United States)

    Jain, Ankesh Dilip; Vsm, Ravisankar; Ksn, Siva Bharani; Km, Sudheesh; Tewathia, Nisha

    2017-09-01

    Pain after any surgical procedure is inevitable but can be controlled by administration of analgesics in most cases. Postoperative pain after surgical treatment of mandibular fractures can be treated by nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics. The purpose of this study is to critically compare the postoperative analgesic efficacy of small doses of intravenous TRAMADOL (opioid analgesic) versus LORNOXICAM (NSAID) in patients with mandibular trauma undergoing open reduction and internal fixation (ORIF) and to assess the presence of any adverse effects due to NSAID or opioid use. Forty adult ASA grade I-II patients with mandibular trauma, scheduled for ORIF under general anesthesia in the Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, were selected for the study. The patients were randomly assigned into a tramadol group (Group T) and a lornoxicam group (Group L) and were administered intravenous tramadol 50 mg and intravenous lornoxicam 8 mg, respectively, at specific postoperative intervals. Pain intensity was quantitatively assessed at the 2nd, 4th, 6th, 12th, and 24th postoperative hours using a visual analog scale of 10 cm. Adverse effects of the analgesics were also recorded and compared. Both the drugs resulted in a significant decrease in pain intensity from 2nd to 24th postoperative hours, but better pain control was observed in Group L at 24th postoperative hour. Only two patients experienced nausea and vomiting in Group T and one patient experienced gastric acidity in Group L. The comparative results clearly demonstrate that pain control by intravenous lornoxicam is significantly better than by intravenous tramadol at 24th postoperative hour after ORIF of mandibular trauma. Side effects produced by both the drugs were minor and had no apparent effect on the study results.

  17. Preauricular transparotid approach to mandibular condylar fractures without dissecting facial nerves.

    Science.gov (United States)

    Yabe, Tetsuji; Tsuda, Tomoyuki; Hirose, Shunsuke; Ozawa, Toshiyuki

    2013-07-01

    Preauricular transparotid approach without dissecting the facial nerve was used for surgical treatment of 15 condylar fractures in 14 patients. The parotid fascia was opened just above the fracture site, and by dissecting the parotid gland and masseter muscle, the fracture was directly exposed. The facial nerve itself was not dissected expressly. All fractures could be reduced accurately and fixed firmly with miniplates. A direct approach just above the fracture site provided good vision of the fracture, avoiding facial nerve palsy caused by strong retraction. Moreover, by not dissecting the facial nerve, the operation time was shortened. This approach was useful for surgical treatment of both condylar neck and subcondylar fractures.

  18. An in vivo evaluation of PLLA/PLLA-gHA nano-composite for internal fixation of mandibular bone fractures.

    Science.gov (United States)

    Peng, Weihai; Zheng, Wei; Shi, Kai; Wang, Wangshu; Shao, Ying; Zhang, Duo

    2015-11-09

    Internal fixation of bone fractures using biodegradable poly(L-lactic-acid) (PLLA)-based materials has attracted the attention of many researchers. In the present study, 36 male beagle dogs were randomly assigned to two groups: PLLA/PLLA-gHA (PLLA-grafted hydroxyapatite) group and PLLA group. PLLA/PLLA-gHA and PLLA plates were embedded in the muscular bags of the erector spinae and also implanted to fix mandibular bone fractures in respective groups. At 1, 2, 3, 6, 9, and 12 months postoperatively, the PLLA/PLLA-gHA and PLLA plates were evaluated by adsorption and degradation tests, and the mandibles were examined through radiographic analysis, biomechanical testing, and histological analysis. The PLLA/PLLA-gHA plates were non-transparent and showed a creamy white color, and the PLLA plates were transparent and faint yellow in color. At all time points following surgery, adsorption and degradation of the PLLA/PLLA-gHA plates were significantly less than those of the PLLA plates, and the lateral and longitudinal bending strengths of the surgically treated mandibles of the beagle dogs in the PLLA/PLLA-gHA group were significantly greater than those of the PLLA group and reached almost the value of intact mandibles at 12 months postoperatively. Additionally, relatively rapid bone healing was observed in the PLLA/PLLA-gHA group with the formation of new lamellar bone tissues at 12 months after the surgery. The PLLA/PLLA-gHA nano-composite can be employed as a biodegradable material for internal fixation of mandibular bone fractures.

  19. Treatment of fractures of the condylar head with resorbable pins or titanium screws: an experimental study.

    Science.gov (United States)

    Schneider, Matthias; Loukota, Richard; Kuchta, Anne; Stadlinger, Bernd; Jung, Roland; Speckl, Katrin; Schmiedekampf, Robert; Eckelt, Uwe

    2013-07-01

    We aimed to compare in vivo the stability of fixation of condylar fractures in sheep using sonic bone welding and standard titanium screws. We assessed stability of the osteosynthesis and maintenance of the height of the mandibular ramus. Height decreased slightly in both groups compared with the opposite side. The volume of the condyle increased considerably in both groups mainly because callus had formed. The results showed no significant disadvantages for pin fixation compared with osteosynthesis using titanium screws.

  20. Is there enough evidence to regularly apply bone screws for intermaxillary fixation in mandibular fractures?

    NARCIS (Netherlands)

    A. Bins; M.A.E. Oomens; P. Boffano; T. Forouzanfar

    2015-01-01

    Purpose Intermaxillary fixation (IMF) is traditionally achieved with arch bars; however, this method has several well-known disadvantages and other techniques, such as bone screws, are available. This study evaluated current evidence regarding these IMF screws (IMFSs) for mandibular trauma and to as

  1. Mandibular symphysis fracture associated with the displacement of a fractured genial segment: An unusual case report with review

    OpenAIRE

    Krishnaveni Buduru; Dalsingh Vankudoth; Darpan Bhargava; Murali Mohan Thota

    2015-01-01

    Fractures and displacement of fragments involving the genial tubercles due to trauma are rarely seen in patients with a full complement of teeth although spontaneous fractures of the genial tubercles in edentulous atrophic mandible are not uncommon. These are usually displaced and may be missed during routine clinical and radiographic examinations owing to superimposition of the features of a fractured mandible. Very few cases have been reported till date. Their implications lie in functional...

  2. The Correlation of Condyle Fracture and Temporomandibular Joint Stiffness Study%髁状突骨折与颞下颌关节强直的相关性研究

    Institute of Scientific and Technical Information of China (English)

    宋永青; 孔亚阁

    2014-01-01

    Objective:To expound condyle fracture and possible mechanism of the temporomandibular joint stiffness occurs and how to prevent condyle fracture caused by the occurrence of the temporomandibular joint stiffness in the clinical work . Method:Studied 80 patients with temporal jaw joint stiffness in our hospital .Analyzed the main disease types and causes of classification .Result:In 80 cases of patients with the disease types of the study found that the possibility of temporomandibular joint stiffness to condylar neck stump and acetabulum bony fusion for the most was 73.75%,etiology research was found that the main cause of temporomandibular joint stiffness was trauma (71.25%).Data comparison had obvious differences between groups ( P<0.05) ,it had statistically significant .Conclusion:Condylar fracture is the main factors of the temporomandibular joint stiff-ness .%目的:阐述髁状突骨折与颞下颌关节强直发生可能的机理及临床工作中怎样预防由髁状突骨折造成颞下颌关节强直的发生。方法:收集近两年来就诊于我院口腔科的颞颌关节强直患者80例进行临床回顾性研究。研究其主要的疾病类型以及病因分类。结果:对80例患者的疾病类型研究发现颞下颌关节强直以髁突颈部残端与关节窝骨性融合的可能性最大占73.75%,病因研究比较发现外伤是造成颞下颌关节强直的主要病因占71.25%。组间的数据比较具有明显的差异(P<0.05),具有统计学意义。结论:髁状突骨折是导致颞下颌关节强直的主要因素。

  3. [Maxillo-facial surgery in skeletal Class II: repercussions on the temporo-mandibular joints].

    Science.gov (United States)

    Manière-Ezvan, Armelle; Savoldelli, Charles; Busson, Floriant; Oueiss, Arlette; Orthlieb, Jean-Daniel

    2016-03-01

    These interventions usually aimed at the correction of the skeletal discrepancy by mandibular retrognatism with an advancement of the distal portion of the mandible after mandibular osteotomy. The position of the condyle is determined during the osteosynthesis with miniplates. Condyles are set back in relation with the supine position of the patient and the weakness of his (her) curarized muscle. All studies show that surgery of mandibular advancement causes a lateral, torque and backward movement of the condyles, all harmful to the condyles. Factors that predispose to condylar resorption are "the patient": a woman, young (between 15 and 40), high mandibular angle, with a history of temporo-mandibular disorders and surgical overload applied to the condyles. What are the possible solutions to avoid failures? Patient preparation before surgery and surgery simulation with an articulator, condylar position control during surgery, working with surgeons to achieve a condylar portion stabilization system (with the CAD), quickly set up a mobilization of the mandible by physiotherapy.

  4. 翼外肌在髁突矢状骨折愈合中对新生骨形成的影响%Changes of New Bone Trabecular Number,Thickness,Gap Width and Bone Volume Fraction and Its Clinical Significance of Pterygoid Muscle in Condyle Fracture

    Institute of Scientific and Technical Information of China (English)

    李燕波; 何志良; 王承阳; 贺成功; 曹雷; 苏丹妮

    2015-01-01

    [Objective] To explore the effects of new bone formation of pterygoid muscle in condyle fracture .[Meth‐ods] A total of 8 healthy sheep were randomly divided into observation and control groups ( n=4 each) .Condylar osteot‐omy was used for mimicking mandibular condyle sagittal fracture .Pterygoid muscle function was retained for observation group and blocked for control group .At Weeks 4 ,12 and 24 ,the changes of new bone trabecular number ,thickness ,gap width and bone volume fraction were recorded .Reverse transcription‐polymerase chain reaction (RT‐PCR) and immuno‐histochemistry were used for detecting the changes of osteocalcin (OCN) ,transforming growth factor‐β1 (TGF‐β1) gene and protein .[Results]With elapsing time ,trabecular number ,thickness and bone volume fraction increased significantly while trabecular gap width significantly decreased in observation group as compared to control group ( P0 .05) .In observation group ,the expressions of OCN mRNA and TGF‐β1 mRNA and positive cell percentage increased significantly ( P <0 .05) .As compared with control group ,the expressions of OCN mRNA and TGF‐β1 mRNA and positive cell percentage were significantly higher in observation group during each period ( P<0 .05) .In control group ,the expressions of OCN mRNA and TGF‐β1 mRNA and positive cell percentage peaked during Week 12 and then decreased significantly ( P <0 .05) .[Conclusion] Pterygoid muscle affects remodeling of condyle shape in healing of sagittal condylar fracture .And the mechanism may be due to a formation of new bone and an aggravation of condyle deformity resulting in joint disk or articular fossa adhesion and ankylosis .%【目的】探讨翼外肌在髁突矢状骨折愈合中对新骨形成的影响。【方法】10只健康绵羊随机分为观察组(5只)和对照组(5只),两组绵羊均通过髁突截骨术造成髁突矢状骨折,观察组保留翼外肌功能,对照组阻断翼外肌功

  5. Influence of two management methods of the condylar fracture on the mandibular growth of rabbits at the developmental stages%兔发育期髁突骨折处理方式对下颌骨发育的影响

    Institute of Scientific and Technical Information of China (English)

    程立军; 卞晓敏; 赵民朝; 潘祥峰

    2012-01-01

    目的 观察髁突颈部骨折骨间固定和非骨间固定对下颌骨生长发育的影响.方法 选取健康新西兰大耳白兔21只,随机分为空白对照组、骨折固定组、骨折非固定组.建立人工下颌骨髁突骨折模型,骨折固定组进行微型钛板坚固内固定术.术后4,8,12周处死动物,进行X线观察、SNB角及下颌骨标本测量.结果 骨折固定组术后各测量值显示左右侧发育不存在明显差异,而骨折非固定组差异明显,尤其在升支高度、髁突长度、下颌骨体长度、下颌角等方面明显.结论 髁突骨折坚固内固定术对下颌骨的生长发育影响较小.%Objective It is to observe the influence of fracture micro-osteosynthesis fixation and non-fixation on the growth of the mandible in mandibular condylar neck fracture. Methods 21 healthy New Zealand rabbits were chosen and randomly divided into blank control group, fixation group and non-fixation group. Mandibular condylar neck fracture models were established, and fracture fixation group was treated with micro-titanium board osteosynthesis fixation. Skull X -ray flank film was observed and SNB angle and the mandible were measured. Results Measurement results of fixation group showed no significant difference between right and left mandible, however, in non-fixed group, significant differences were observed, especially in sticks height, the length of the mandible and the condyle, the mandibular angle height. Conclusion Rigid internal fixation has less influence on the mandibular grouth of rabbits at the developmental stage.

  6. Is The Late Mandibular Fracture From Third Molar Extraction a Risk Towards Malpractice? Case Report with the Analysis of Ethical and Legal Aspects

    Directory of Open Access Journals (Sweden)

    Weuler dos Santos Silva

    2017-06-01

    Full Text Available Objectives: The present study reports a case of late mandibular fracture due to third molar extraction and highlights the inherent clinical, ethical and legal aspects related to this surgical complication. Material and Methods: A female patient underwent surgical procedure for the extraction of the mandibular right third molar. Two days after the surgery the patient reported pain and altered occlusion in the right side of the mandible. After clinical and radiographic re-examination, the diagnosis of late mandibular fracture was established. A second surgery, under general anaesthesia, was performed for the fixation of the mandibular bone. Results: The fractured parts were reduced and fixed with locking plate systems and 2 mm screws following load-sharing principles. The masticatory function showed optimal performance within 7 and 21 days after the surgery. Complete bone healing was observed within 1 year of follow-up. Conclusions: For satisfactory surgical outcomes, adequate surgical planning and techniques must be performed. Signed informed consents explaining the risks and benefits of the treatment must be used to avoid ethical and legal disputes in dentistry.

  7. 可吸收线张力带合并克氏针交叉固定治疗儿童陈旧性肱骨外髁骨折%Absorbable thread tension with the needle was merged cross ifxed treat children chronic humerus lateral condyle fracture

    Institute of Scientific and Technical Information of China (English)

    江政晃; 余舒鹏

    2016-01-01

    目的:探讨可吸收线张力带合并克氏针治疗儿童陈旧性肱骨外髁骨折的治疗效果及儿童肱骨外髁骨折治疗的注意事项和经验。方法回顾性研究2014年1月至2016年1月江西中医药大学附属医院收治的18例陈旧性肱骨外髁骨折患儿临床资料,均采用可吸收线张力带合并克氏针交叉固定治疗,术后定期随访患儿骨折愈合情况。结果18例患儿均获得随访。骨折愈合时间4~12周,平均6周。无术后感染、神经损伤、肱骨小头缺血坏死、骨不连等并发症。肘关节活动根据 hardacre的疗效标评估,优16例(88.9%),良2例(11.1%)。结论可吸收线张力带合并克氏针交叉固定治疗儿童陈旧性肱骨外髁骨折获得较为满意的治疗效果;肱骨外髁骨折骨折的处理第一要务就是在于早期的诊断,及时正确的治疗,防止陈旧性肱骨外髁骨折的产生,而对于陈旧性肱骨外髁骨折的早期手术治疗却能够使得肘关节的外观和功能得到有效的纠正。%Objective to explore the absorbable thread tension with the needle was merged the curative effect of treating children chronic humerus lateral condyle fracture and children humerus condyle fracture treatment considerations and experience.Methods retrospective study between January 2014 and January 2014 in jiangxi university of traditional Chinese medicine affiliated hospital of 18 cases of pulmonary humerus lateral condyle fracture with clinical data, adopts absorbable thread tension with the needle was merged cross fixed treatment, postoperative follow-up on a regular basis with fracture healing.Results 18 cases were follow-up. Fracture healing time 4 ~ 12 weeks, 6 weeks on average. No postoperative infection, nerve injury, capitellum complications such as ischemic necrosis, bone nonunion. Elbow movement according to the curative effect of hardacre standard evaluation, optimal 16 cases (88.9%), good in 2 cases (11

  8. An immunohistochemical study of TGF-β1 in monkey mandibular condyle following gradually induced occlusal disorder%*紊乱对猴髁突软骨中TGF-β1分布的影响

    Institute of Scientific and Technical Information of China (English)

    陈金武; 王美青; 姚秀芳; 刘豆豆

    2001-01-01

    目的:探讨渐进性咬合紊乱所致猴颞下颌关节退形性变中,髁突软骨TGF-β1的分布变化特点及其意义。方法:2只青年恒河猴分成实验组和对照组。采用拔牙和固定矫治技术造成实验组后牙渐进性咬合紊乱。8月后,对髁突进行HE染色和TGF-β1免疫组化定量分析。结果:①实验组髁突前内侧出现明显的退性形变,与对照猴相比,其髁突各部位软骨厚度均变薄(P<0.01),其中变化程度最大者为前部内份,其次是髁突前部中份和中部内份。②与对照猴相比,实验组髁突软骨各部位TGF-β1表达均升高(P<0.01)。结论:渐进性咬合紊乱可导致髁突退性形变,髁突软骨中TGF-β1表达明显增强,TGF-β1可能参与了关节软骨的修复活动。%Objective:To elucidate the effects of gradually induced occlusal disorder on the expression of TGF-β1 in temporomandibular condyle of monkey. Methods:In a monkey after extraction of right upper first molar and left lower first molar, a fixed orthodontic appliance was used to cause the adjacent teeth inclined to the space and to occlude with opposite in-coordinately. Another monkey was used as the control.8 months later, the animals were sacrificed and bilateral temporomandibular condyles were examined with histologic and immunohistochemical methods.Results:In the animal with teeth-extraction, degenerative changes were found in anterior medial part of condyles, the thickness of condylar cartilage decreased significantly, especially in the anterior parts of medial and central thirds, and also the intermediate part of medial third (P<0.01). A significant increase of TGF-β1 in condylar cartilage was found when compared with normal control (P<0.01).Conclusion:Gradually induced occlusal disorder can lead to degenerative changes in monkey temporomandibular joint with increased TGF-β1 expression in condylar cartilage.TGF-β1 may participate in cartilage repairing during the

  9. New miniplate for osteosynthesis of mandibular angle fractures designed to improve formation of new bone.

    Science.gov (United States)

    Pituru, Teodora Silagieva; Bucur, Alexandru; Gudas, Claudiu; Pituru, Silviu-Mirel; Marius Dinca, Octavian

    2016-04-01

    The purpose of this article is to present the study of a new miniplate designed to keep the maximum strains developed in the cortical bone near the fracture line during accidental biting to values below the threshold causing bone resorption. Designed to offer maximum fracture stability with minimal implanted volume and patient intrusion, the design uses a novel approach to account for the effects of the distance from the fracture line to the nearest screws. Its geometry minimizes the peak forces that can develop during most cases of mandible biomechanical loadings. A three-dimensional (3D) osteosynthesis finite element model for a human mandible confirmed the operational effectiveness of the miniplate. It also provided numerical estimates for the strains and screw forces in the cortical surface during incisor bites with clinically relevant forces of 200 N. Two prototypes, 0.6 mm and 0.8 mm in thickness, were repeatedly tested on fractured sheep mandibles, fixed in a purpose-built jig, to loads up to 150% of the maximum forces developed by human patients. The tests indicated good fracture stability, and the proof tests carried for each of the two prototypes terminated at more than 350 N due to failure of the loading cable and respectively, secondary mandible fractures occurring away from the miniplate.

  10. Mandibular fracture after removal of third molar. Report of five cases of a rare complication

    Directory of Open Access Journals (Sweden)

    Constantinos MOUROUZIS

    2014-04-01

    Full Text Available A rare complication of the surgical removal of a third molar is the fracture of the mandible. A series of cases of such fractures is here presented. Material and method: It is retrospective study of cases treated at the OMFS dept of KAT Hospital. Results: The patients were 3 females and 2 males, with a mean age of 50.4 years. In all cases the fracture was located at the angle of the mandible and in two cases it was complicated with osteomyelitis. In four cases open reduction and internal fixation was undertaken and in one case intermaxillary fixation only. Following treatment, fracture healing without problem was achieved in all cases. Conclusions: Fracture of the mandible, as a complication of surgical removal of a third molar is an infrequent but severe situation. Neglected postextractive fractures have increased risk for development of osteomyelitis. When removing impacted third molars, the surgeon should implement an atraumatic technique, by removing as less bone as possible. In high risk cases precise instructions must be given to the patients and the significance of soft diet must be highlighted.

  11. Comparative study on the osseous changes of the TMJ and mandibular asymmetry after conservative or operative treatment in condylar fracture patients

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Su Kyoung; Kim, Kyung A; Kwon, Ki Jeong; Koh, Kwang Joon [Chonbuk National University College of Medicine, Chonju (Korea, Republic of)

    2003-12-15

    To compare the effects of the conservative treatment and operative treatment by observation of osseous changes of the TMJ and mandibular asymmetry in condylar fracture patients. 33 condylar fracture patients (17 with conservative and 16 with operative treatment) were included in this study. After a minimum of 6 months after the surgical procedure, patients were given a follow up examination of the osseous changes using a transcranial view. Differences in the osseous changes of both groups were compared and the asymmetry indices were calculated on a postero-anterior skull view. The TMJ of the operative treatment group showed more significant osseous changes than the conservative treatment group. The affected TMJ showed more significant osseous changes than the unaffected TMJ in the both groups. The unaffected TMJ of the conservative group and the affected TMJ of the operative group showed significant osseous changes. The mandibular asymmetry indices in the conservative and operative group were 5.12 and 7.30 respectively at the time of treatment, and 2.39 and 3.41 respectively at the follow-up. But the mandibular asymmetry between the both groups showed no statistical differences. The TMJ of the operative group showed more significant osseous changes than the conservative group, but the mandibular asymmetry between the both groups showed no statistical differences.

  12. Marginal quality and fracture strength of root-canal treated mandibular molars with overlay restorations after thermocycling and mechanical loading.

    Science.gov (United States)

    Dere, Mustafa; Ozcan, Mutlu; Göhring, Till N

    2010-08-01

    To evaluate marginal quality, fracture modes, and loads-to-failure of different overlay restorations in rootcanal treated molars in a laboratory setup. Thirty-two mandibular first molars were randomly assigned to four groups (n = 8): UTR= untreated (control), RCT-COM= root canal treated (RCT)+ lab-made composite overlay, RCT-FRC= RCT+composite resin overlay with two layers of multidirectional woven glass fibers; RCT-CER: RCT+ceramic overlay. The teeth in all groups were subjected to thermocycling and mechanical loading (TCML) in a computer-controlled masticator (1,200,000 loads, 49 N, 1.7 Hz, 3000 temperature cycles of 5°C to 50°C). Marginal adaptation was evaluated before and after TCML with scanning electron microscopy at 200X at the tooth-to-luting composite (IF1) and luting composite-to restoration (IF2) interfaces. After TCML, all specimens were loaded to failure in a universal testing machine at 0.5 mm/min. Data were analyzed with ANOVA and Bonferroni correction. Marginal adaptation decreased from 93 ± 3.4 to 82 ± 6.5 % at IF1 after TCML (p > 0.001) but the decrease was not significant between the groups (p = 0.8130). At IF2, ceramic overlays showed about 10% lower marginal adaptation than composite overlays (p control (p = 0.0019). While the fractures in the UTR occurred exclusively above the cementoenamel junction (Mode 1 and Mode 2) and were rated reparable, RCT-COM and RCT-CER showed exclusively catastrophic failures in varying modes (nodes 3 to 5). Only in group RCT-FRC, half of the specimens fractured in a reparable fracture mode (modes 1 and 2) with veneering composite delamination from the glass-fiber weaver layer. As cusp-covering overlay restorations in root canal treated molars, composite resin overlays with and without fiber reinforcement performed similar to intact teeth with varying failure types. While intact teeth failed exclusively in reparable modes, all other restorations failed in a catastrophic manner, except half of the fiber

  13. A qualitative engineering analysis of occlusion effects on mandibular fracture repair mechanics.

    Science.gov (United States)

    Katona, Thomas R

    2011-01-01

    Objectives. The purpose of this analytical study was to examine and critique the engineering foundations of commonly accepted biomechanical principles of mandible fracture repair. Materials and Methods. Basic principles of static equilibrium were applied to intact and plated mandibles, but instead of the traditional lever forces, the mandibles were subjected to more realistic occlusal forces. Results. These loading conditions produced stress distributions within the intact mandible that were very different and more complex than the customary lever-based gradient. The analyses also demonstrated the entirely different mechanical environments within intact and plated mandibles. Conclusions. Because the loading and geometry of the lever-idealized mandible is incomplete, the associated widely accepted bone stress distribution (tension on top and compression on the bottom) should not be assumed. Furthermore, the stress gradients within the bone of an intact mandible should not be extrapolated to the mechanical environment within the plated regions of a fractured mandible.

  14. Characterization and Management of Mandibular Fractures: Lessons Learned from Iraq and Afghanistan

    Science.gov (United States)

    2013-03-01

    Defense. a Dental and Trauma Research Division, U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Building 3611, Fort Sam Houston, TX 78234...will usually require multiple surgeries and coordination with critical care, neurosurgery, plastic surgery, anesthesia , and frequently psychiatry, speech...Because of the high infection rate of open fractures, these should be treated with antibiotic prophylaxis. General anesthesia and paralytics are useful in

  15. Three-dimensional assessment of unilateral subcondylar fracture using computed tomography after open reduction

    Directory of Open Access Journals (Sweden)

    Sathya Kumar Devireddy

    2014-01-01

    Full Text Available Objective: The aim was to assess the accuracy of three-dimensional anatomical reductions achieved by open method of treatment in cases of displaced unilateral mandibular subcondylar fractures using preoperative (pre op and postoperative (post op computed tomography (CT scans. Materials and Methods: In this prospective study, 10 patients with unilateral sub condylar fractures confirmed by an orthopantomogram were included. A pre op and post op CT after 1 week of surgical procedure was taken in axial, coronal and sagittal plane along with three-dimensional reconstruction. Standard anatomical parameters, which undergo changes due to fractures of the mandibular condyle were measured in pre and post op CT scans in three planes and statistically analysed for the accuracy of the reduction comparing the following variables: (a Pre op fractured and nonfractured side (b post op fractured and nonfractured side (c pre op fractured and post op fractured side. P < 0.05 was considered as significant. Results: Three-dimensional anatomical reduction was possible in 9 out of 10 cases (90%. The statistical analysis of each parameter in three variables revealed (P < 0.05 that there was a gross change in the dimensions of the parameters obtained in pre op fractured and nonfractured side. When these parameters were assessed in post op CT for the three variables there was no statistical difference between the post op fractured side and non fractured side. The same parameters were analysed for the three variables in pre op fractured and post op fractured side and found significant statistical difference suggesting a considerable change in the dimensions of the fractured side post operatively. Conclusion: The statistical and clinical results in our study emphasised that it is possible to fix the condyle in three-dimensional anatomical positions with open method of treatment and avoid post op degenerative joint changes. CT is the ideal imaging tool and should be used on

  16. A comparison of MRI, radiographic and clinical findings of the position of the TMJ articular disc following open treatment of condylar neck fractures.

    Science.gov (United States)

    Schneider, Alexander; Zahnert, Diana; Klengel, Steffen; Loukota, Richard; Eckelt, Uwe

    2007-10-01

    We examined the position and function of the articular disc after open treatment of condylar fractures by comparing magnetic resonance images (MRI) and radiographs with clinical data. MRI and radiographs were taken after treatment of 28 patients with 33 fractures of the mandibular condyles. In all cases, the disc was located in the fossa after open reduction and internal fixation (ORIF). The MRI, radiographic and clinical findings did not correlate, and damage to the temporomandibular joint (TMJ) could be seen more clearly on MRI than on clinical or radiographic examination. Damage to soft tissues seen on MRI after treatment was more pronounced in dislocated than in displaced fractures.

  17. Sialocele: A rare sequlae of transparotid approach in subcondylar fracture management.

    Science.gov (United States)

    Rajeev, R; Sajesh, S; Jose, Mathew; Kumar, N Dhineksh

    2016-01-01

    Iatrogenic injury and/or damage to the parotid salivary gland during transparotid approach for open reduction and internal fixation of mandibular condyle fracture is a rare event. Accumulation of saliva in the gland leads to formation of a sialocele. Huge sialocele often seeks drain through the most dependent area through an extraoral wound, whereas in the absence of extraoral fistula, saliva can be redirected intraorally using a stent. A case of mangement of sialocele caused by damage to glandular elements during a transparotid approach for a subcondylar fracture reduction is reported. The various conservative methods and surgical management for this condition are discussed.

  18. Fratura de mandíbula: análise de 293 pacientes tratados no Hospital de Clínicas da Universidade Federal de Uberlândia Mandibular fracture: analysis of 293 patients treated in the Hospital of Clinics, Federal University of Uberlândia

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2005-10-01

    foi tratamento mais comumente empregado. A complicação mais freqüente foi a osteomielite.Mandibular fracture is the second most common facial fracture and there has been a significant increase in number of cases in the last years. Misidentification and inadequate treatment can take to permanent aesthetic or functional deformity. AIM: Evaluate cases of mandibular fracture reduction in the Hospital of Clinics of the Federal University of Uberlândia, from January of 1974 to December of 2002. STUDY DESIGN: historical cohort. PATIENT AND METHOD: Two hundred and ninety-three cases of reduction of mandibular fractures were retrospectively analyzed according to factors related to: patient, trauma, signs and symptoms, and surgical treatment. RESULTS: There has been a clear tendency of increase of the number of mandibular fractures along the years. There was higher prevalence in male (4:1, with occurrence peak between 20 to 29 years old. The principal causes of fracture in this study were traffic accidents and violence, representing 72.4%. One hundred and thirty-five patients presented only one fracture. The most injured sites were, in decreasing order, symphysis, condyle, angle, body, ramus, and coronoid. We performed closed reduction (28, open reduction (213 and association of the two (11 patients; 56.8% of the patients were treated within the first 3 days; and, 50.4% were discharged from the hospital until the first postoperative day. About 10% of the patients presented complications, being osteomyelitis the most frequent one. CONCLUSION: The incidence of mandibular fractures was remarkably larger in the male sex, during the third decade of life. The most common cause was traffic accident, and symphysis and condyle were the most injured sites. Isolated fractures occurred in over half of the cases. Most of the patients were treated in the first three days and were discharged until the first postoperative visit. Closed reduction was the treatment most commonly employed

  19. Mandibular reconstruction with composite microvascular tissue transfer

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, J.J. III; Wooden, W.A. (Emory Univ. School of Medicine, Atlanta, GA (USA))

    1990-10-01

    Microvascular free tissue transfer has provided a variety of methods of restoring vascularized bone and soft tissue to difficult defects created by tumor resection and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular reconstruction, 15 for primary squamous cell carcinoma of the floor of the mouth or tongue, 7 for recurrent tumor, and 6 for other reasons (lymphangioma (1), infection (1), gunshot wound (1), and osteoradionecrosis (3)). Primary reconstruction was performed in 19 cases and secondary in 9. All repairs were composite flaps including 12 scapula, 5 radial forearm, 3 fibula, 2 serratus, and 6 deep circumflex iliac artery. Mandibular defects included the symphysis alone (7), symphysis and body (5), symphysis-body-ramus condyle (2), body or ramus (13), and bilateral body (1). Fourteen patients had received prior radiotherapy to adjuvant or curative doses. Eight received postoperative radiotherapy. All patients had initially successful vascularized reconstruction by clinical examination (28) and positive radionuclide scan (22 of 22). Bony stability was achieved in 25 of 26 patients and oral continence in 24 of 26. One complete flap loss occurred at 14 days. Complications of some degree developed in 22 patients including partial skin necrosis (3), orocutaneous fistula (3), plate exposure (1), donor site infection (3), fracture of reconstruction (1), and fracture of the radius (1). Microvascular transfer of bone and soft tissue allows a reliable reconstruction--despite previous radiotherapy, infection, foreign body, or surgery--in almost every situation in which mandible and soft tissue are absent. Bony union, a healed wound, and reasonable function and appearance are likely despite early fistula, skin loss, or metal plate or bone exposure.

  20. Fracture patterns in the maxillofacial region: a four-year retrospective study

    Science.gov (United States)

    2015-01-01

    Objectives The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures. PMID:26734557

  1. Experimental and numerical predictions of Biomet(®) alloplastic implant in a cadaveric mandibular ramus.

    Science.gov (United States)

    Mesnard, M; Ramos, A

    2016-05-01

    The purpose of this study was to evaluate experimentally the behaviors of an intact and an implanted cadaveric ramus, to compare and analyze load mechanism transfers between two validated finite element models. The intact, clean cadaveric ramus was instrumented with four rosettes and loaded with the temporal reaction load. Next, the Biomet microfixation implant was fixed to the same cadaveric mandibular ramus after resection. The mandibular ramus was reconstructed from computed tomographic images, and two finite element models were developed. The experimental results for the mandibular ramus present a linear behavior of up to 300 N load in the condyle, with the Biomet implant influencing strain distribution; the maximum influence was near the implant (rosette #4) and approximately 59%. The experimental and numerical results present a good correlation, with the best correlation in the intact ramus condition, where R(2) reaches 0.935 and the slope of the regression line is 1.045. The numerical results show that screw #1 is the most critical, with maximum principal strains in the bone around 21,000 με, indicating possible bone fatigue and fracture. The experimental results show that the Biomet temporomandibular joint mandibular ramus implant changes the load transfer in the ramus, compared to the intact ramus, with its strain-shielding effect. The numerical results demonstrate that only three screws are important for the Biomet TMJ fixation. These results indicate that including two proximal screws should reduce stresses in the first screws and strains in the bone.

  2. Computed Tomographic Evaluation of Condylar Symmetry and Condyle-Fossa Relationship of the Temporomandibular Joint in Subjects with Normal Occlusion and Malocclusion: A Comparative Study

    Science.gov (United States)

    Ponnada, Swaroopa Rani; Gaddam, Kranthi Praveen Raju; Perumalla, Kiran; Khan, Imran; Mohammed, Naqeed Abdul

    2017-01-01

    Introduction The relationship of the condyle and the mandibular fossa differs in shape with type of malocclusion and skeletal pattern. A review of literature shows till date there are no studies on Temporomandibular Joint (TMJ) condyle-fossa relation to the type of malocclusion based on growth pattern. Computed Tomography (CT) provides optimal imaging of the osseous components of the TMJ. Aim The purpose of this study was to investigate the condyle-fossa relationship and the dimensional and positional symmetries between the right and left condyles in subjects with normal occlusion and malocclusion in different growth patterns utilizing the CT scans of the TMJ. Materials and Methods Sixty subjects with age group of 18-30 years were selected for the study. The sample was divided into three groups based on overbite and growth pattern. The groups included 20 subjects with normal occlusion and average growth pattern, 20 patients with horizontal growth pattern and deep bite, 20 patients with vertical growth pattern and deep bite. The depth of the mandibular fossa, the condyle-fossa relationship, and the concentric position of the condyles were evaluated by the images obtained from the sagittal slices. ANOVA was performed to assess the significance. If it was found significant, post-hoc Tukey’s test was performed to see which two groups were statistically significant. Results No statistically significant difference was found in the anterior joint space and the superior joint space in horizontal and vertical growers with deep bite. Statistically significant (p <0.05) posterior positioning of the condyles was observed (nonconcentric positioning) in vertical growers with deep bite. Conclusion There is a significant change in the position of the condyle in vertical growers compared to average and horizontal growers. Left condyle is more anteriorly placed than the right condyle in all the three groups. There is no significant change in the vertical depth of the mandibular

  3. Study on imaging analysis using three-dimensional CT system for mandibular condylar fracture. Establishing quantitative classification

    Energy Technology Data Exchange (ETDEWEB)

    Kurokawa, Hideto [National Defence Medical Coll., Tokorozawa, Saitama (Japan)

    1997-11-01

    We examined 13 patients with fractures of the condylar process (7 men, 6 women) by using 3-dimensional images. A break-down of 15 examined joints revealed 11 patients with unilateral and 2 patients with bilateral fractures of the condylar process. Eight joints of healthy control individual (2 men and 2 women) were used as controls. Fractures of the condylar process and healthy controls were compared, which comparison led to the following conclusions: Bone fragments of deviated fractures may move slightly within the joint, preferentially internally and medially; following displaced fractures, internal and downward movement of bone fragments within the joint is observed; after the occurrence of deviated dislocation fractures, bone fragments protrude from the joint and clearly move internally and inferiorly, showing a rotation of the bone fragments; after the occurrence of displaced dislocation fractures, bone fragments also protrude from the joint and clearly move anteriorly and inferiorly; sometimes an internal rotation of the bone fragments is observed; and with linear fractures there is only minimal overall increase in, and characteristic changes are not observed. Regarding diagnosis, the classical classification of fractures of the condylar process does not provide a classification for linear fractures. Thus, this type has to be newly added to the common classification: Fissure fractures (type I), Deviated fractures (type II), Displaced fractures (type III), Deviated dislocation fractures (type IV), Displaced dislocation fractures (type V), Longitudinal (type VI). (author)

  4. Development of a Titanium Plate for Mandibular Angle Fractures with a Bone Defect in the Lower Border: Finite Element Analysis and Mechanical Test

    Directory of Open Access Journals (Sweden)

    Douglas Rangel Goulart

    2015-09-01

    Full Text Available Objectives: The aim of the present study was to develop a plate to treat mandibular angle fractures using the finite element method and mechanical testing. Material and Methods: A three-dimensional model of a fractured mandible was generated using Rhinoceros 4.0 software. The models were exported to ANSYS®, in which a static application of displacement (3 mm was performed in the first molar region. Three groups were assessed according to the method of internal fixation (2 mm system: two non-locking plates; two locking plates and a new design locking plate. The computational model was transferred to an in vitro experiment with polyurethane mandibles. Each group contained five samples and was subjected to a linear loading test in a universal testing machine. Results: A balanced distribution of stress was associated with the new plate design. This plate modified the mechanical behavior of the fractured region, with less displacement between the fractured segments. In the mechanical test, the group with two locking plates exhibited greater resistance to the 3 mm displacement, with a statistically significant difference when compared with the new plate group (ANOVA, P = 0.016. Conclusions: The new plate exhibited a more balanced distribution of stress. However, the group with two locking plates exhibited greater mechanical resistance.

  5. Comparison of a 2.0-mm locking system with conventional 2.0- and 2.4-mm systems in the treatment of mandibular fractures: a randomized controlled trial.

    Science.gov (United States)

    Camino Junior, Rubens; Moraes, Rogério Bonfante; Landes, Constantin; Luz, João Gualberto C

    2017-06-12

    A comparative study of the use of the 2.0-mm locking fixation system with conventional systems in the treatment of mandibular fractures was performed. For this study, 87 consecutive patients with 112 mandibular fractures were randomized to receive either 2.0-mm locking plates (n = 45) or conventional 2.0- or 2.4-mm plates (n = 42) and had a minimum follow-up of 6 months. Fractures were classified based on the degree of displacement and complexity. Statistical analyses were used to verify possible differences between the groups when separately compared unfavourable and favourable cases (p ≤ 0.050). Despite randomization, systemic diseases were more frequent in the 2.0-mm locking group in favourable cases. Substance abuse occurred predominantly in the 2.0-mm locking group, in unfavourable and favourable fractures. There were more cases of complex fractures in the conventional group in unfavourable cases. One case involving a major postoperative complication occurred in the locking group (2.2%) and three cases occurred in the conventional group (7.1%) but with no significant difference between groups. In this study, there were no major differences between conventional and locking 2.0-mm locking systems with regard to the outcome of treated mandibular fractures, showing that both are adequate as long as the criteria of their indication and requirements for installation are met. It was concluded that the 2.0-mm locking fixation system can replace conventional systems in the treatment of mandibular fractures; in addition, this approach was effective in the treatment of unfavourable fractures that typically require the 2.4-mm conventional system.

  6. Mandibular trauma: a two-centre study

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Karagozoglu, K.H.; Gallesio, C.; Forouzanfar, T.

    2015-01-01

    The aims of this study were to assess and compare epidemiological data on mandibular fractures from two European centres and to perform a review of the literature. Between 2001 and 2010, a total of 752 patients with a total of 1167 mandibular fractures were admitted to a hospital in Turin, and 245 p

  7. Evaluation of in vitro resistance of titanium and resorbable (poly-L-DL-lactic acid) fixation systems on the mandibular angle fracture.

    Science.gov (United States)

    Bregagnolo, L A; Bertelli, P F; Ribeiro, M C; Sverzut, C E; Trivellato, A E

    2011-03-01

    The purpose of this study was to compare, by mechanical in vitro testing, a 2.0-mm system made with poly-L-DL-lactide acid with an analogue titanium-based system. Mandible replicas were used as a substrate and uniformly sectioned on the left mandibular angle. The 4-hole plates were adapted and stabilized passively in the same site in both groups using four screws, 6.0mm long. During the resistance-to-load test, the force was applied perpendicular to the occlusal plane at three different points: first molar at the plated side; first molar at the contralateral side; and between the central incisors. At 1mm of displacement, no statistically significant difference was found. At 2mm displacement, a statistically significant difference was observed when an unfavourable fracture was simulated and the load was applied in the contralateral first molar and when a favourable fracture was simulated and the load was applied between the central incisors. At the failure displacement, a statistically significant difference was observed only when the favourable fracture was simulated and the load was applied on the first molar at the plated side. In conclusion, despite more failure, the poly-L-DL-lactic acid-based system was effective.

  8. Usefulness of the retromandibular transparotid approach for condylar neck and condylar base fractures.

    Science.gov (United States)

    Kim, Bae-Kyung; Kwon, Yong-Dae; Ohe, Joo Young; Choi, Yong-Ha; Choi, Byung-Joon

    2012-05-01

    Condyle fractures represent 20% to 30% of all mandibular fractures and are thus among the most common facial fractures. The fracture pattern can vary greatly and may occur anywhere along the line from the sigmoid notch to the mandibular angle. The main problems are access, difficulty in repositioning the extremely slender fragments, and fixation of the condyle.Eighty-seven patients were diagnosed with condylar neck or condylar base fractures from January 2007 to December 2009 in the Department of Oral & Maxillofacial Surgery of Kyung Hee University Dental Hospital. In this study, we included 35 patients who underwent open surgery and a total of 28 patients who were treated using a retromandibular transparotid approach.Surgical treatment aims were anatomic repositioning and rigid fixation of the fragments, occlusal stability, rapidly return to function, maintenance of vertical ramus dimension, no airway compromise, and reduced long-term temporomandibular joint dysfunction. Considering the high rate of occurrence of condylar fracture and the importance of the condylar as a growth center of the mandible, extraoral approaches for the open reduction of condylar fractures are considered effective and can be used widely.Short access route, easy reduction, short operating time, and stable postoperative occlusion are the advantages of the retromandibular transparotid approach. Also, there was no permanent damage from facial nerve injury, salivary leakage, or preauricular hypoesthesia. Therefore, the retromandibular transparotid approach is considered a safe and effective method for patients with a condylar neck or condylar base fracture classified according to the Strasbourg Osteosynthesis Research Group's classification, who require surgical treatment with an extraoral approach.

  9. Conservative Approach to Unilateral Condylar Fracture in a Growing Patient: A 2.5-Year Follow Up

    Science.gov (United States)

    Tuna, Elif Bahar; Dündar, Aysun; Çankaya, Abdülkadir Burak; Gençay, Koray

    2012-01-01

    Condylar fractures in children are especially important because of the risk of a mandibular growth-center being affected in the condylar head, which can lead to growth retardation and facial asymmetry. The purpose of this article is to follow up the two and half year clinical and radiological evaluation of the conservative treatment of a 10 year-old patient, who had a unilateral green-stick type fracture. The patient presented with painful facial swelling localized over the left condylar region, limited mouth-opening and mandibular deviation to the left. Panoramic radiography and computed tomography confirmed the diagnosis of incomplete fracture on the left condyle with one side of the bone fractured and the other bent. Closed reduction was chosen to allow for initial fibrous union of the fracture segments and remodeling with a normal functional stimulus. A non-rigid mandibular splint was applied in order to remove the direct pressure on the fracture side of the mandible. Clinical and radiologic examination after 30 months revealed uneventful healing with reduction of the condylar head and remodeling of the condylar process following conservative treatment. PMID:22276078

  10. Pin fixation in treatment of dislocated lateral condyle of the humerus in pediatric population

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe R.

    2004-01-01

    Full Text Available Introduction Fractures of lateral condyle represent 17% of all pediatric fractures of the distal humerus, and in current pediatric orthopedics there is still no agreement regarding optimal treatment modalities. We presented a treatment protocol for pediatric dislocated fractures of the lateral condyle of the humerus used at the Pediatric Surgery Clinic in Novi Sad. Material and methods Over the study period (1991-2000 a total of 48 patients with dislocated fractures of the lateral condyle of the humerus were hospitalized at the Pediatric Surgery Clinic. Orthopedic reduction and percutaneous pin fixation under radiological supervision was done in 15 patients, while 33 patients needed surgical reduction and pin fixation. Results Satisfactory results were obtained in 42 patients (91.3%, out of which 29 patients (63.1% presented with excellent resuls. Good results were obtained in 8 patients (17.4%, and fair results in 5 patients (10.8%. Unsatisfactory results were present in 4 patients (8.7%. Two patients were lost to follow-up. Discussion Dislocation fractures of the lateral condyle represent high risk for development of complications. Adequate diagnosis and treatment represent basic conditions for successful post-interventional result. Orthopedic reduction with percutaneous pin fixation is recommended for fractures that may be anatomically reduced. In cases of unsatisfactory results of reduction, as well as in cases with completely dislocated and rotated fragments, surgical reduction and pin fixation is necessary. Conclusions Satisfactory results in 91.3% of cases, and long-term experience suggest that the recommended therapeutic option is adequate in treatment of dislocated fractures of the lateral condyle of the humerus in pediatric population.

  11. 骨性下颌前突正畸—正颌联合治疗前后髁突位置变化的研究%Changes in mandibular condyle positions before and after bilateral sagittal split ramus osteotomy for mandibular prognsthism

    Institute of Scientific and Technical Information of China (English)

    王海燕; 段银钟; 田晓光; 肖华

    2012-01-01

    AIM; By observing whether there exixt condylar position changes before and after orthodonticLsurgical treatment, to investigate whether bilateral sagittal split ramus osteotomy(BSSRO)can be safely used to correct skeletal class III malocclusion with mandibular hyperplasia without causing additional TMJ symptoms. METHODS: Fifteen patients with mandibular prognathism were included in this study. The patients were treated with orthodontic and bilateral sagittal split ramus osteotomy (BSSRO). Both sides of the anterior, posteria and upper spaces were measured two weeks before and six months after the operation respectively. The data was analyzed by SPSS 16. 0 software package for paired t test. RESULTS:After treatment, oral function was recovered and facial esthetic effect was improved in all 15 patients. Before operation,the left mean anterior, posterior and upper spaces were 1. 91 mm,2. 30 mm and 2. 51 mm. The right mean anterior, posterior and upper spaces were 2. 14 mm, 2. 65 mm and 2. 98 mm. After operation,the left mean anterior, posterior and upper spaces were 1. 99 mm, 2. 38 mm and 2. 62 mm. The right mean anterior, posterior and upper spaces were 2. 14 mm,2. 66 mm and 2. 60 mm. There was no statistical significant difference among the 3 spaces pre and post operation with BSSRO (P >0. 05 ). CONCLUSION: Combined orthodontic and BSSRO can be used safely to correct skeletal class III malocclusion with mandibular hyperplasia without causing additional TMJ symptoms.%目的:研究骨性下颌前突正畸-正颌联合治疗前后髁突位置的变化,探讨下颌双侧升支矢状劈开后退术对于治疗骨性下颌前突的可靠性和安全性.方法:15例骨性下颌前突的安氏Ⅲ类错(牙合)畸形病人,行下颌双侧升支矢状劈开后退术(bilateral sagittal split ramus osteotomy,BSSRO)与正畸矫治联合治疗,分别在术前两周和术后半年拍摄许勒式X线片,测量BSSRO术前、术后双侧髁突在关节窝内前、后、上间隙的

  12. Clinical Characteristics and Treatment of Fractures of Mandibular Condyloid Process%下颌骨髁状突骨折临床特征及治疗的探讨

    Institute of Scientific and Technical Information of China (English)

    刘蔚; 陈昶; 李明达; 胡翰青

    2014-01-01

    目的:探讨下颌骨髁状突骨折的临床特点及治疗。方法将71例髁状突骨折患者按治疗方法的不同分为手术组(25例,采用手术切开复位内固定术)及非手术组(46例,采用手法复位)。对2组患者的年龄、性别、受伤因素、骨折部位及类型、治疗方式及并发症等方面进行分析。结果髁状突骨折好发于21~30岁人群,发病率男性高于女性,主要致伤原因为交通事故(56.34%),骨折线多位于髁状突颈部(60.56%)。治疗后随访1年,手术组患者在最大张口度、咬牙合关系、颞下颌关节疼痛、下颌骨活动度等方面与非手术组比较差异均无统计学意义(均 P >0.05)。结论髁状突骨折好发于青中年男性,交通事故为主要致伤原因,髁颈是好发部位;髁状突骨折的治疗应综合考虑患者的骨折部位、移位程度、复位难易程度、年龄、全身情况以及患者的意愿等方面来决定。%Objective To investigate the clinical characteristics and treatment of fractures of the mandibular condyloid process.Methods Seventy-one patients with fractures of the mandibu-lar condyloid process were assigned to receive either open reduction and internal fixation (opera-tion group,n=25)or manual reduction (non-operation group,n=46).The age,gender,etiology, fracture site,fracture type,treatment method and complications were analyzed in both groups.Re-sults Fractures of the mandibular condyloid process often occurred in people between 21 and 30 years of age,and the incidence in males was higher than that in females.The main cause of frac-tures of the mandibular condyloid process was traffic accident (56.34%),and the fracture line was mainly located at condylar neck (60.56%).After 1 year of follow-up,no significant differ-ences in maximal mouth opening,normal occlusion,temporomandibular joint pain and mandibular activity were found between the two groups (P >0

  13. 内、外固定结合治疗合并髁部骨折的股骨干复杂骨折%External fixation combined with minimal invasion internal fixation for complex diaphyses fracture combined with femur condyle fractures

    Institute of Scientific and Technical Information of China (English)

    万春友; 马宝通; 辛景义; 金鸿宾; 刘爱峰

    2009-01-01

    目的 探讨合并髁部骨折的股骨干复杂骨折(A0 C2、C3型)的外固定支架手术治疗方法及后续治疗的临床效果评价.方法 对2001年1月-2007年1月通过手术治疗的累及股骨髁骨折的42例股骨干粉碎性骨折患者的治疗结果进行分析.按AO/ASIF原则分类,股骨干中远端骨折分别为C2型(多段骨折)18例,C3型(不规则)骨折24例.手术采用简单内固定加外固定架固定C3型,单纯外固定架固定C2型;4例采用续贯固定.结果 42例患者全部获随访,按Kotmert股骨远端骨折功能评价标准,膝关节功能满意35例(83%),可6例(14%),不满意1例(2%).结论 通过外固定支架的方法治疗合并髁部骨折的股骨干复杂骨折(A0 C2、C3型)可最大限度地恢复股骨的相对长度,且便于在术后对股骨关节面与股骨干纵轴进行水平和纵向调整,使其与对侧股骨中下段达到解剖平行对称关系;术后配合合理的康复锻炼,能使膝关节功能得到最大的恢复.股骨管状结构重建在此类骨折的治疗中应受到重视.%Objective To discuss external fixation method for the complex diaphyses fracture involving condyles of femur and evaluate its clinical efficacy.Methods A retrospective study was done on 42 patietns with comminuted femur diaphyses fracture combined with distal intra-articular fractures treated surgically from January 2001 to Janurary 2007.There were 24 males and 18 females at mean age of 33 years (20-66 years).According to AO/ASIF classification,there were 18 patients with type C2 fractures and 24 with type C3 ones.Simple internal fixation plus external fixation was performed on patitents with C3 fractures but only external fixation on those with C2 fractures.Four patients were treated with intramedular fixation.Results All patients were followed up for 1-12 months.According to Kotmert's assessment standard on function of proximal femur,the knee function was satisfactory in 35 patients (83% ) ,good in six (14

  14. Maintenance of condylar position in a patient with mandibular deficiency

    Directory of Open Access Journals (Sweden)

    Nicolaos TOPOUZELIS, Maria LAZARIDOU, Nicolaos LAZARIDIS, Christos ILIOPOULOS

    2011-12-01

    Full Text Available Maintaining the preoperative position of condyles within the temporal fossa is necessary in any orthognathic surgery, in order to ensure a stable postoperative result and the normal functioning of the temporomandibular joints. A variety of condylar positioning devices have been described to help preserve the preoperative position of condyles within the temporal fossa and prevent temporomandibular joint disorders or relapses.Case report: A 18-year-old female patient presented with a severe class II maxillofacial deformity, which was treated with sagittal split mandibular osteotomy and simultaneous genioplasty with the use of a polytetrafluoroethylene allograft. A condylar positioning device was used to maintain the preoperative position of the condyles. The patient did not develop any temporomandibular joint symptoms postoperatively, and the final skeletal result remained stable despite the considerable anterior displacement of the peripheral mandibular segment.

  15. Variations of femoral condyle shape.

    Science.gov (United States)

    Biscević, Mirza; Hebibović, Mujo; Smrke, Dragica

    2005-12-01

    The aim of this study is to mathematically approximate the shape of the femoral articulating line and compare radiuses of condylar curves within and between males and females. Ten male and ten female participants were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation. Average radiuses of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point respectively. Males had longer curve radiuses of both condyles (p knee geometry, and other ellipsoidal structures in human body, like wrist, scull segments, dental arches, etc.

  16. Nursing Experience for a Case of Mandibular Fractures with Simultaneous Implants Placement%下颌骨骨折同期牙种植1例的护理体会

    Institute of Scientific and Technical Information of China (English)

    查大慧; 李玉红; 程旭; 孙子环; 黄伟

    2015-01-01

    Objective:To investigate the nursing care of the patient with open reduction and rigid internal fixation of jaw fracture with simultaneous dental implantation in general anesthesia.Methods: One case of mandibular fractures combined with tooth loss and alveolar bone Comminuted fracture.Reduction of mandibular fractures with the same period of dental implantation was operated in general anesthesia and the management of preoperative nursing was strengthenedfor the special nursing.Result: All incisions were primary healing.Mandibular fractures were satisfied with quality of reduction under postoperative panoramic radiographs,no titanium plate fracture or loose.Implant insertion direction and osseointegration werewell,no infection,loose or fall-off.Conclusion: Standardized nursing care in preoperative nursing can improve the success rate of dental implantation under general anesthesia.%目的:探讨全麻颌骨骨折切开复位坚强内固定术同期牙种植术的护理配合方法.方法:总结下颌骨骨折患者1例护理体会,全麻下行下颌骨骨折复位同期植入种植牙,并加强围术期规范化护理,针对下颌骨骨折复位同期植入种植牙术做特征性护理.结果:患者术后创口Ⅰ期愈合,术后全景片示下颌骨骨折对位愈合良好,无钛板断裂、松动现象;种植体植入方向及骨结合良好,无感染、松动、脱落.结论:全麻下种植牙围术期规范化护理可提高种植牙手术成功率.

  17. Radiographic study of mandibular asymmetry

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Yeon Hwa; Cho, Bong Hae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    1998-02-15

    The purpose of this study was to perform the radiographic measurements and temporomandibular joint evaluation in mandibular asymmetry. For this study, thirty-two patients who have mandibular asymmetry were selected and submentovertex, panoramic and lateral corrected tomographic radiographs were taken. Horizontal and vertical analysis using various landmarks on these radiographs were performed. Also radiographic and clinical evaluation of temporomandibular joint were obtained. The results were as follows: 1. On the submentovertex radiograph, the mean distance of Pogonion to midline was 5.0 {+-} 3.8 mm. 2. The mean distance of Pogonion to Gonion between the deviated and the contra-lateral side (p<0.001). 3. The distance difference of Pogonion to Gonion between the deviated and the contra-lateral side was significantly related to the degree of asymmetry (p<0.001). 4. On panoramic radiograph,the condylar height of the contral-lateral side was significantly longer than the one of the deviated side (p<0.001). 5. On lateral corrected tomogram, bony of temporomandibular joint was observed in 11 condyles of the deviated side and 9 condyles of the contra-lateral side. Erosion and ostephyte were the most common changes in both the deviated and the contra-lateral sides.

  18. Microcomputed tomographic analysis of human condyles in unilateral condylar hyperplasia: increased cortical porosity and trabecular bone volume fraction with reduced mineralisation

    NARCIS (Netherlands)

    Karssemakers, L.H.E.; Nolte, J.W.; Tuinzing, D.B.; Langenbach, G.E.J.; Raijmakers, P.G.; Becking, A.G.

    2014-01-01

    Unilateral condylar hyperplasia or hyperactivity is a disorder of growth that affects the mandible, and our aim was to visualise the 3-dimensional bony microstructure of resected mandibular condyles of affected patients. We prospectively studied 17 patients with a clinical presentation of progressiv

  19. Analysis and discuss the related factors in patients with knee joint function after operation of fracture of femoral condyle%股骨髁间骨折术后患者膝关节活动功能的相关因素

    Institute of Scientific and Technical Information of China (English)

    廖建晖; 李志跃

    2016-01-01

    者膝关节活动功能的相关因素有年龄、ISS 评分、骨折分型、关节囊的处理、复位质量以及是否进行 CPM 功能锻炼等。术后积极主动进行功能锻炼,有利于股骨髁间骨折患者的膝关节活动功能的恢复。%Objective To discuss the relationship between femoral condyle fracture of related factors affecting patients with knee joint activities, and to analyze its related factors. Methods From April 2013 to January 2014, our hospital between 96 cases of femoral condyle fracture patients selected cases were retrospectively analyzed. 56 cases of male and female 40;Aged 20 66, the average 43+ /-2.5 years old. Causes: traffic accident caused by 48 cases, 29 cases caused by falling, pres-sure caused by 12 cases, 10 cases were caused by direct violence. Muller points type: type C1 52 cases, 38 cases C2 type, C3 type 6 cases. Postoperative severity score (ISS) score 12~29 points, an average of 20.5 points; Operation according to the injury time 4 24 h d, an average of 7 d. Internal fixation using LISS steel plate 58 cases, retrograde interlocking intramedullary nails and 22 cases, cancellous screws, bolts in 16 cases. By unconditional Logistic regression models were discussed, according to the may affect the functional factors of postoperative patients with knee joint activities into gender groups (men and women), age (young and middle-aged and older) group, the preoperative ISS group, fracture type, operation units, surgical approach, internal fixation group, the knee joint capsule treatment group, the reduction and quality group and whether CPM functional exercise group, comparing the efficacy of the groups of patients. Results the gender men as good group accounted for 87.50% (49/56), gender group for women good accounted for 80.00% (32/40), there were no statistically significant difference. Age young and middle-aged group for fine accounted for 86.79% (46/53), in the elderly group for fine group accounted for 72

  20. The 3-dimensional miniplate is more effective than the standard miniplate for the management of mandibular fractures: a meta-analysis.

    Science.gov (United States)

    Liu, Yong; Wei, Bo; Li, Yuxiang; Gu, Dawei; Yin, Guochao; Wang, Bo; Xu, Dehui; Zhang, Xuebing; Kong, Daliang

    2017-02-14

    The study aimed to determine the superiority between 3-dimensional (3D) miniplate and standard miniplate for mandibular fractures (MFs) treatment. Controversial results on the use of standard miniplate and 3D miniplate have remained for management of MFs. Several electronic databases were retrieved up to September 2014 to identify eligible studies. The quality of studies was assessed, and the relative risk (RR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size. Subgroup analyses by different fracture regions and different 3D miniplate sizes were performed. Publication bias was measured by a funnel plot. There were 13 studies included for the meta-analysis, consisting of 593 participants. The 3D miniplate achieved significant lower incidences of malocclusion (RR 0.43, 95% CI 0.24-0.77, P = 0.004) and hardware failure (RR 0.31, 95% CI 0.13-0.74, P = 0.008) than the standard miniplate. There were no significant differences between the two miniplates on the incidence of the remaining outcomes: wound dehiscence, infection, paresthesia, and nonunion/malunion. Subgroup analyses indicated that 3D miniplate caused a lower hardware failure than standard with the size of 8 or 10 holes (RR 0.23, 95% CI 0.08-0.66, P = 0.006). Besides, publication bias was not detected. The 3D miniplate is superior to the standard miniplate on the reduction of postoperative complication rates for the management of MFs. More holes in the 3D miniplate might contribute to a successful treatment.

  1. A correlational study of serum alkaline phosphatase level and developmental mandibular laterognathism.

    Science.gov (United States)

    Dai, Jiewen; Li, Hongliang; Yu, Hongbo; Si, Jiawen; Fang, Bing; Shen, Steve Guofang

    2015-03-01

    The abnormal cartilage/bone metabolism in unilateral condyle may be a direct factor that contributes to developmental mandibular laterognathism. However, although many molecules have been demonstrated to play crucial roles in the development of temporomandibular joints, the exact molecular mechanisms that lead to the disrupted condylar cartilage/bone development were greatly unknown. In this retrospective study, our findings revealed that serum alkaline phosphatase (ALP) level in adult patients with developmental mandibular laterognathism was lower than that in control subjects, and the serum ALP levels continue to reduce in adult patients (>20 years old). Although the exact relationship between the lower serum ALP level and developmental mandibular laterognathism is unclear, the findings further support the opinion that the condylar growth may sustain for a long time in the affected condyle in patients with developmental mandibular laterognathism and offer an alternative choice to use total serum ALP activity as a possible biomarker to assess condylar growth activity in patients with developmental mandibular laterognathism.

  2. Microcomputed tomographic analysis of human condyles in unilateral condylar hyperplasia: increased cortical porosity and trabecular bone volume fraction with reduced mineralisation.

    Science.gov (United States)

    Karssemakers, L H E; Nolte, J W; Tuinzing, D B; Langenbach, G E J; Raijmakers, P G; Becking, A G

    2014-12-01

    Unilateral condylar hyperplasia or hyperactivity is a disorder of growth that affects the mandible, and our aim was to visualise the 3-dimensional bony microstructure of resected mandibular condyles of affected patients. We prospectively studied 17 patients with a clinical presentation of progressive mandibular asymmetry and an abnormal single-photon emission computed tomographic (SPECT) scan. All patients were treated by condylectomy to arrest progression. The resected condyles were scanned with micro-CT (18 μm resolution). Rectangular volumes of interest were selected in 4 quadrants (lateromedial and superoinferior) of the trabecular bone of each condyle. Variables of bone architecture (volume fraction, trabecular number, thickness, and separation, degree of mineralisation, and degree of structural anisotrophy) were calculated with routine morphometric software. Eight of the 17 resected condyles showed clear destruction of the subchondral layer of cortical bone. There was a significant superoinferior gradient for all trabecular variables. Mean (SD) bone volume fraction (25.1 (6) %), trabecular number (1.69 (0.26) mm(-1)), trabecular thickness (0.17 (0.03) mm), and degree of mineralisation (695.39 (39.83) mg HA/cm(3)) were higher in the superior region. Trabecular separation (0.6 (0.16) mm) and structural anisotropy (1.84 (0.28)) were higher in the inferior region. The micro-CT analysis showed increased cortical porosity in many of the condyles studied. It also showed a higher bone volume fraction, greater trabecular thickness and trabecular separation, greater trabecular number, and less mineralisation in the condyles of the 17 patients compared with the known architecture of unaffected mandibular condyles.

  3. [Condylar fracture and temporomandibular joint ankylosis].

    Science.gov (United States)

    Zhang, Yi

    2016-03-01

    This article summarized the advances in treatment and research of temporomandibular joint surgery in the last 5 years which was presented in "The 2nd Condyle Fracture and Temporomandibular Joint Ankylosis Symposium". The content includes 5 parts: non-surgical treatment of children condyle fracture and long-term follow-up, the improvement of operative approach for condyle fracture and key techniques, the importance and the method for the simultanesous reduction of disc in condylar fracture treatment, the development of traumatic temporomandibular joint ankylosis similar to hypertrophic non-union and the improved safety and accuracy by applying digital surgery in joint surgery.

  4. Morphological changes of condyles and Helkimo clinical dysfunction index in patients treated with Herbst--orthodontic appliance.

    Science.gov (United States)

    Aidar, Luís Antônio de Arruda; Abrahão, Márcio; Yamashita, Hélio K; Dominguez, Gladys Cristina

    2013-01-01

    This study evaluated the morphological changes in the temporomandibular joint (TMJ) condyles and calculated the Helkimo clinical dysfunction index (CDI) in adolescents with Class II Division 1 malocclusion and mandibular retrognathism treated with the Herbst appliance (phase I) and fixed orthodontic appliances (phase II). Thirty-two consecutive adolescents underwent phase I, and 23 completed phase II. The TMJs were evaluated qualitatively using magnetic resonance imaging (MRI) at the beginning of treatment (T1), during phase I (T2), at the end of phase I (T3) and at the end of phase II (T4). The CDI was calculated at T1, T3 and T4. From T1 to T3 (p=0.326), there were no changes in condyle morphology in 86.0% of the TMJs. From T3 to T4 (p<0.05) and T1 to T4 (p<0.05), changes occurred in 39.1% and 43.4% of the condyles. No significant changes in CDI occurred from T1 to T3, T3 to T4 and T1 to T4 (p=1.000; 86.6%, 76.2% and 76.2% concordance). After phase I, there were practically no changes in condyle morphology. At the end of phase II, a mild flattening was observed in some condyles. It may be concluded that no significant changes occurred in CDI after both treatment phases.

  5. Clinical study of microsplint and circumferential wiring in the treatment of mandibular body fracture in children%微型夹板配合环颌结扎治疗儿童下颌体部骨折的研究

    Institute of Scientific and Technical Information of China (English)

    姜刚勇

    2015-01-01

    目的:探讨微型夹板配合环颌结扎固定在儿童下颌骨体部骨折治疗中的应用。方法:选择2009~2012年儿童下颌体部骨折23例,采用微型夹板配合环颌结扎固定,观察其疗效。结果:微型夹板配合环颌结扎固定方法对儿童下颌骨骨折进行治疗具有不损伤恒牙胚,骨折复位良好、固定稳固、不影响进食,便于口腔清洁的特点。结论:微型夹板配合环颌结扎固定是治疗儿童下颌骨体部骨折的有效方法。%Objective:To evaluate the application of microsplint and circumferential wiring in the treatment of mandibular body frac-ture in children.Methods:23 children with mandibular body fracture were treated by microsplint and circumferential wiring from 2009 to 2012,the effects of treatment were assessed.Results:Treatment with microsplint and circumferential wiring did not injure perma-nent teeth germ.It showed many features,such as easy reduction of fractured bone segments,stable fixation,without interfere with eat-ing and benefit of mouth clearness.Conclusion:Microsplin and cicumferential wiring is effective for the treatment of mandibular body fracture in children.

  6. Open or closed repositioning of mandibular fractures: is there a difference in healing outcome? A systematic review

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Storgård Jensen, Simon; Kofod, Thomas

    2008-01-01

    The clinical outcome of closed vs open reduction and rigid fixation was compared based on a systematic review of the literature. Ten non-randomized retrospective studies were found. In six of these ten studies, the complication rate was significantly increased when open reduction and plating...... or wires. Nerve injuries were slightly increased when open reduction was found (although not significant). With regard to occlusal disturbances, no difference was found in the open and closed reduction group. Concerning overall complication problems, six of seven studies showed more problems after open...... in case of more complicated fractures cannot be excluded, which might explain the differences found between the two procedures. Prospective, randomized clinical trials are needed to illuminate this problem....

  7. Evaluation of Fractured Condylar Head Along the Sagittal Plane: Report of Three Cases

    OpenAIRE

    Rajesh Kumar, Bekal Pattathan; Rai, Kirthi Kumar; Shiva Kumar, H. R.; Upasi, Amarnath P.; Shah, Ashwin

    2011-01-01

    There are case reports of sagittal fractures of the condylar head leading to bifid condyle. However bifid condyles maybe found in patients with no history of trauma. A split in the saggital plane of the condyle is not visible with a lateral, oblique or panaromic radiographs but only with anteriorposterior, transorbital projections or CT scan of the temperomandibular joint. The chances of condyle being split in the sagittal plane may be due to the medial pole extending beyond the condylar neck...

  8. Increased mandibular condylar growth in mice with estrogen receptor beta deficiency

    OpenAIRE

    Yosuke, Kamiya; JING, Chen; Manshan, Xu; Achint, Utreja; Thomas, Choi; Hicham, Drissi; Sunil, Wadhwa

    2013-01-01

    Temporomandibular joint (TMJ) disorders predominantly afflict women of childbearing age, suggesting a role for female hormones in the disease process. In long bones, estrogen acting via estrogen receptor beta (ERβ) inhibits axial skeletal growth in female mice. However, the role of ERβ in the mandibular condyle is largely unknown. We hypothesize that female ERβ deficient mice will have increased mandibular condylar growth compared with wild type (WT) female mice. This study examined female 7-...

  9. Assessment of the fracture resistance of teeth instrumented using 2 rotary and 2 reciprocating files versus the Self-Adjusting File (SAF: An ex vivo comparative study on mandibular premolars

    Directory of Open Access Journals (Sweden)

    Ajinkya M Pawar

    2016-01-01

    Full Text Available Aim: Current ex vivo study compared fracture resistance of teeth instrumented using 5 endodontic files, filled with Gutta-percha and AH Plus. Materials and Methods: Sixty freshly extracted, single-rooted mandibular premolars were acquired and decoronated to obtain 15 mm segments. These samples were randomly divided into six groups (n = 10. Group 1 served as the control containing untreated samples (without instrumentation or filling. In Groups 2-6, samples were instrumented using rotary (Universal ProTaper and Revo-S, reciprocating (WaveOne and RECIPROC; , and self-adjusting file (SAF, respectively. Following instrumentation, the samples were filled by lateral compaction with Gutta-percha and AH Plus. A week later, after the sealer was completely set, a vertical load was applied to the specimen′s canal in each group until fracture. The loads required for fracture were recorded, and statistical analysis was performed. Results: The mean fracture load differed significantly among the groups (P 0.05 and was significantly higher than that of the 2 rotary and reciprocating groups (P < 0.01. Conclusion: The samples instrumented by the SAF exhibited a better fracture resistance.

  10. A retrospective analysis of growth of the constructed condyle-ramus in children with hemifacial microsomia.

    Science.gov (United States)

    Mulliken, J B; Ferraro, N F; Vento, A R

    1989-10-01

    A retrospective analysis of changes in costochondral rib grafts used to construct the condyle-ramus in children with hemifacial microsomia (HFM) was made. The mean age at surgical correction was 6.5 years, and the average follow-up was 4.5 years. Direct measurements were made on panoramic radiographs. The condyle-ramus length was expressed as a percentage change comparing the constructed with the normal side. During the first 2 postoperative years, there was either no change or a slight decrease in the length of the rib graft. After 2 years, however, the costochondral graft elongated at a slow, irregular rate. The mode change was 11 percent over the postoperative study period. In four patients who exhibited rapid growth of the normal condyleramus (greater than the mean change of 0.94 cm), the constructed side failed to keep pace. In another group of four patients who exhibited moderate elongation of the normal side, the grafted side grew commensurately or demonstrated greater than normal percentage change in length. There was no correlation between the initial size of the costochondral graft, age at time of operation, or presenting type of mandibular deformity. These findings are discussed in terms of the intrinsic growth and the functional matrix theories of mandibular development.

  11. Isolated mandibular condylar metastases: An uncommon manifestation of recurrent cervical cancer

    Directory of Open Access Journals (Sweden)

    Ameya D Puranik

    2013-01-01

    Full Text Available Bone metastases from recurrent cervical cancer is a rare scenario, with commonly involved sites being lumbar spine and pelvic bones report an extremely rare manifestation of cervical cancer recurrence presenting as a painful jaw swelling due to metastasis to the mandibular condyle.

  12. Do the changes in muscle mass, muscle direction, and rotations of the condyles that occur after sagittal split advancement osteotomies play a role in the aetiology of progressive condylar resorption?

    NARCIS (Netherlands)

    Dicker, G.J.; Castelijns, J.A.; Tuinzing, D.B.; Stoelinga, P.J.W.

    2015-01-01

    Changes in cross-sectional area (CSA), volume (indicating muscle strength), and direction of the masseter and medial pterygoid muscles after surgical mandibular advancement were measured, along with the rotation of the condyles after bilateral sagittal split osteotomies (BSSOs) to advance the mandib

  13. Evaluation of three-dimensional position change of the condylar head after orthognathic surgery using computer-aided design/computer-aided manufacturing-made condyle positioning jig.

    Science.gov (United States)

    Kim, Hyung-Mo; Baek, Seung-Hak; Kim, Tae-Yun; Choi, Jin-Young

    2014-11-01

    This study was performed to evaluate the efficacy of computer-aided design/computer-aided manufacturing (CAM/CAD)-made condyle positioning jig in orthognathic surgery. The sample consisted of 40 mandibular condyles of 20 patients with class III malocclusion who underwent bilateral sagittal split ramus osteotomy with semirigid fixation (6 men and 14 women; mean age, 25 y; mean amount of mandibular setback, 5.8 mm). Exclusion criteria were patients who needed surgical correction of the frontal ramal inclination and had signs and symptoms of the temporomandibular disorder before surgery. Three-dimensional computed tomograms were taken 1 month before the surgery (T1) and 1 day after the surgery (T2). The condylar position was evaluated at the T1 and T2 stages on the axial, frontal, and sagittal aspects in the three-dimensional coordinates. The linear change of the posterior border of the proximal segment of the ramus between T1 and T2 was also evaluated in 30 condyles (15 patients), with the exception of 10 condyles of 5 patients who received mandibular angle reduction surgery. There was no significant difference in the condylar position in the frontal and sagittal aspects (P > 0.05). Although there was a significant difference in the condylar position in the axial aspect (P < 0.01), the amount of difference was less than 1 mm and 1 degree; it can be considered clinically nonsignificant. In the linear change of the posterior border of the proximal segment of the ramus, the mean change was 1.4 mm and 60% of the samples showed a minimal change of less than 1 mm. The results of this study suggest that CAD/CAM-made condyle positioning jig is easy to install and reliable to use in orthognathic surgery.

  14. Fractura patológica de la mandíbula asociada a quiste radicular: Reporte de 3 casos clínicos Mandibular pathologic fracture associated with radicular cyst: Report of three clinical cases

    Directory of Open Access Journals (Sweden)

    J. Bouguila

    2008-08-01

    Full Text Available Introducción. El quiste radicular es el quiste más común de los maxilares. Su tamaño puede variar desde una lesión que abarca el proceso alveolar hasta uno extenso que oblitera el espacio antral maxilar o causa una fractura patológica mandibular. Reporte de casos. Se reportan tres casos con fractura patológica mandibular asociados a quiste radicular ocurridos después de trauma facial. El diagnóstico fue sugerido por un estudio clínico, radiografía panorámica y confirmado por el estudio histopatológico de la pieza operatoria. El tratamiento consistió en enucleación quística seguido por inmovilización de fragmentos con osteosíntesis o bloqueo intermaxilar. El resultado clínico y radiológico a corto plazo fue favorable. Discusión. Se discuten aspectos propios de la patología y su terapia. Conclusión. El éxito del tratamiento depende de una adecuada terapia en que sus principios más importantes son la remoción de la lesión mediante enucleación y una fijación estable.Introduction. Radicular cyst is the most common cyst of the oral cavity. It may range in size from a small periapical lesion to one that can obliterate the antral space or cause mandibular fracture. Case reports. We report three cases of radicular cyst complicated by mandibular fracture that occurred after maxillofacial trauma. The diagnosis was strongly suggested by panoramic radiography and confirmed by pathology examination of the operative specimen. Treatment consisted in cyst enucleation followed by immobilization of fragments by osteosynthesis or maxillomandibular fixation. The clinical and radiologic outcome was favorable. Discussion. The particularities and treatment are discussed. Conclusion. Treatment success is dependent on adequate therapy, the principles of which are removing the lesion and providing stable fixation.

  15. Difficulties encountered in preauricular approach over retromandibular approach in condylar fracture.

    Science.gov (United States)

    Jayavelu, Perumal; Riaz, R; Tariq Salam, A R; Saravanan, B; Karthick, R

    2016-10-01

    Fracture of mandible can be classified according to its anatomical location, in which condylar fracture is the most common one overall and is missed on clinical examination. Due to the unique geometry of the mandible and temporomandibular joint, without treatment the fractures can result in marked pain, dysfunction, and deformity. The condylar fracture may be further classified depending on the sides involved: unilateral/bilateral, depending on the height of fracture: intracapsular (within the head of condyle), extracapsular - head and neck (high condyle fracture), and subcondylar (low condyle fracture), and depending on displacement: nondisplaced, displaced (anteromedially, medially, and lateral), and dislocated. The clinical features include swelling and tenderness over the temporomandibular joint region, restricted mouth opening, and anterior open bite. A 34-year-old male patient reported to the Department of Oral and Maxillofacial Surgery at Madha Dental College and Hospital; suffered fall trauma resulting in bilateral condyle fracture, dentoalveolar fracture in mandible with restricted mouth opening, and anterior open bite.

  16. The role of trauma on temporomandibular joint ankylosis and mandibular growth retardation: an experimental study.

    Science.gov (United States)

    Oztan, Hasan Yucel; Ulusal, Betul Gozel; Aytemiz, Cemal

    2004-03-01

    The purpose of this pilot study was to analyze the role of different types of trauma in the formation of temporomandibular joint ankylosis. The specific aim was to explore the physical and histological effects of trauma on temporomandibular joint and mandibular growth. Fifty-five growing white male guinea pigs were used for the study. Initially, cadaveric studies were performed (n = 1) to assess the topographic anatomy of the temporomandibular joint region. Animals were then assigned to pilot (n = 4), experimental (n = 40), and control (n = 10) groups. The pilot group was used to assess the technical feasibility of creating various trauma types and endurance of the animals to the surgery. Four types of trauma were carried out in the experimental group: A) intra-articular hematoma (n = 10), B) mechanical damage to the articular surface (n = 10), C) fracture of the condyle neck (n = 10), and D) excision of the condyle head (n = 10). Each trauma group was further divided into two subgroups. Procedures were performed unilaterally or bilaterally in the subgroups. In the control group, no procedure was performed. Subjects were examined after a 2-month follow-up period. The development and anatomical structure of the mandible were evaluated, and histopathological assessment of the temporomandibular joint was carried out in each group. The results revealed that hyaline cartilage of the condylar head had an important role in the development of the mandible and traumas targeting this site may cause ankylosis, growth retardation, and resultant facial malformations. Hence, mechanical damage to the articular surface (B1, B2) and resection of the condylar head (D1, D2) almost always resulted in ankylosis. Intra-articular hematoma alone (A1, A2) was established not be a causative factor for ankylosis formation, however.

  17. Premenstrual ears parotid incision approach in the treatment of mandibular condylar fractures%经耳前腮腺小切口径路治疗髁突中位骨折

    Institute of Scientific and Technical Information of China (English)

    李击; 徐友良; 刘正祥; 肖军

    2016-01-01

    目的:探讨经耳前腮腺径路治疗髁突中位骨折的方法。方法:回顾性分析经耳前腮腺径路治疗髁突中位骨折26例35侧的临床资料,记录术前、术后的腮腺涎漏、张口受限程度、面神经损伤及咬合紊乱等情况,通过术前、术后曲面断层片评估骨折复位与愈合状况。结果:全部病例手术过程顺利。手术时间平均(1.5±0.3)h;伤口一期愈合;全部病例均获得良好的咬合关系;3例出现涎瘘,经加压包扎后治愈;张口度恢复至3.5 cm。术后1~3个月复查曲面断层片显示骨折复位及愈合良好;4例出现暂时性面瘫,术后3~6个月复查面瘫症状消失。结论:经耳前腮腺小切口径路治疗髁突中位骨折可获得满意效果。%Objective:To evaluate the effects of pre-auricular parotid gland approach in the treatment of mandibular condylar neck fracture. Method:Clinical data of patients with mandibular condylar neck fracture (26 patients,35 temporo-mandibular joints) were collected and analyzed retrospectively. The clinical information of pre-and post-operative parotid salivary fistula,limited mouth opening,facial nerve injury and malocclusion was recorded respectively. Meanwhile,pre- and post-operative panoramic images were used to evaluate the reductive and healing state of the fractures. Result:All the op-erations were uneventful, with an average operation time 1.5 hours,(mean ±SD,1.5 ±0.3). The wound healed well and a good occlusion was achieved in all the patients. Parotid salivary fistula occurred in 3 patients after operation , but disap-peared after pressure dressing. A mouth opening over 3.5cm was achieved in all the patients. The post-operative panoramic images (1~3 months later) showed the fracture reduction and healing was good. Facial paralysis occurred in four patients after operation, but disappeared 3~6 months later. Conclusion:The effects of pre-auricular parotid gland approach in the

  18. Clinical trial of pantomography for the evaluation of mandibular trauma.

    Science.gov (United States)

    Johnston, C C; Doris, P E

    1980-08-01

    A trial study was conducted comparing the standard "four view" mandibular series and pantomography for th evaluation of mandibular trauma. During the six-month trial period a series of 17 patients with a total of 24 mandibular fractures was compiled. The pantomographs were more easily interpreted than the standard views because overlapping structures were blurred and spatial orientation was clear. In eight of the 17 patients the fractures were more clearly visualized by pantomography. Because the entire mandibule was seen so well on the pantomographs, no special views were required. Eleven patients had single fractures, which are in fact quite common.

  19. 单颌牙弓夹板+颌内钢丝结扎法治疗下颌骨正中骨折16例%Single Maxillary Dental Arch Splint+Jaw Steel Wire Ligation in Treatment of 12 Cases of Fracture of Mandibular Median

    Institute of Scientific and Technical Information of China (English)

    潘树矿; 陆开睿

    2015-01-01

    目的探讨单纯性下颌骨正中骨折的非手术治疗方式。方法应用单颌牙弓夹板和颌内钢丝结扎对下颌骨骨折处进行固定制动4w,为下颌骨正中骨折的愈合创造固定的外部条件。结果16例下颌骨正中骨折的患者4 w后拆除牙弓夹板,骨折断端愈合良好,咬合关系恢复正常。结论单颌牙弓夹板和颌内钢丝结扎治疗单纯性下颌骨正中骨折,能对骨折处有效的制动,有利于口腔卫生的保持,避免二次手术拆除内固定所用的钛板,经济实用。%Objective To study the non operation treatment of simple mandibular fracture.Methods Applicationofsinglemaxil arydental arch splint and intermaxil ary wiring on mandibular fracture were fixed brake 4 weeks, healing of mandibular fracture fixation for the creation of the external conditions. Results 16 cases of mandibular fractures in patients with the 4 week after removal of dental arch splint broken ends of fracture healing, good, normal occlusal relationship. Conclusion Single maxil ary dental arch splint and jaw steel wire ligation in the treatment of median simple mandible fracture, fracture is ef ective to brake, is conducive to maintaining oral hygiene, avoid titanium plate two times operation removal of internal fixation using, economical and practical.

  20. Assessment of osteoarthrosis of the temporomandibular joint associated with avascular necrosis of the condyle on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Segami, Natsuki; Murakami, Ken-ichiro; Hosaka, Hideo; Moriya, Yoshiyuki; Miyaki, Katsuaki; Chen, Wen-Hsi; Iizuka, Tadahiko (Kyoto Univ. (Japan). Faculty of Medicine)

    1993-02-01

    Osteoarthrosis associated with findings of avascular necrosis of the mandibular condyle on magnetic resonance imaging was clinically evaluated. The subjects consisted of 5 female unilateral cases, with an average age of 55.4 years who had a mean duration of illness of 15.2 months. The symptoms were a mean interincisal opening distance of 32.8 mm with arthralgia in mild to moderate degree, and joint noise (crepitation) in all joints. MRI documented decreasing signal intensity of the condyle with 2 joints in high degree and 3 joints in moderate, as well as variable low signal density of the articular eminence, associated with concomitant anterior disk displacement. X-ray showed deformity of the condyle and eminence. The operative findings disclosed disk rupture and comparatively smooth cartilage with minimum remodeling of the condylar surface; however, avascular evidence was suggested when corticotomy was performed. 4 joints underwent diskectomy, condylar shaving, auricular cartilage grafts and corticotomy of the condyle. Arthroscopic corticotomy was applied for 1 joint with mild symptoms. Postoperative symptoms improved to mean opening distance of 41.4 mm and disappeared arthralgia in 4 joints. The surgical outcome was excellent in 3 joints and good in 2 joints. Follow-up MRI in 2 cases disclosed increasing signal intensity, which suggested recovery of condylar vascularity following corticotomy. It is suggested that the low-signal intensity on MRI in osteoarthrosis might indicate avascular lesions of the condyle, secondary to degenerative change. Histological investigations are required to evaluate avascular necrosis of the temporomandibular joints. (author).

  1. Collagen turnover after tibial fractures

    DEFF Research Database (Denmark)

    Joerring, S; Krogsgaard, M; Wilbek, H

    1994-01-01

    Collagen turnover after tibial fractures was examined in 16 patients with fracture of the tibial diaphysis and in 8 patients with fracture in the tibial condyle area by measuring sequential changes in serological markers of turnover of types I and III collagen for up to 26 weeks after fracture...... collagen. A group comparison showed characteristic sequential changes in the turnover of types I and III collagen in fractures of the tibial diaphysis and tibial condyles. The turnover of type III collagen reached a maximum after 2 weeks in both groups. The synthesis of type I collagen reached a maximum...... after 2 weeks in the diaphyseal fractures and after 6 weeks in the condylar fractures. The degradation of type I collagen increased after 4 days and reached a maximum at 2 weeks in both groups. The interindividual variation was wide. On a group basis, the turnover of types I and III collagen had...

  2. Evaluation of fractured condylar head along the sagittal plane: report of three cases.

    Science.gov (United States)

    Rajesh Kumar, Bekal Pattathan; Rai, Kirthi Kumar; Shiva Kumar, H R; Upasi, Amarnath P; Shah, Ashwin

    2012-06-01

    There are case reports of sagittal fractures of the condylar head leading to bifid condyle. However bifid condyles maybe found in patients with no history of trauma. A split in the saggital plane of the condyle is not visible with a lateral, oblique or panaromic radiographs but only with anteriorposterior, transorbital projections or CT scan of the temperomandibular joint. The chances of condyle being split in the sagittal plane may be due to the medial pole extending beyond the condylar neck, moreover the condyle is composed of cancellous bone covered by a thin layer of cortical bone. Here we are presenting three case reports of Saggital split condyles and stress the need for inclusion of these type of fractures in the classification of condylar fractures.

  3. Histochemical evidences on the chronological alterations of the hypertrophic zone of mandibular condylar cartilage.

    Science.gov (United States)

    Hossain, Kazi Sazzad; Amizuka, Norio; Ikeda, Nobuyki; Nozawa-Inoue, Kayoko; Suzuki, Akiko; Li, Minqi; Takeuchi, Kiichi; Aita, Megumi; Kawano, Yoshiro; Hoshino, Masaaki; Oda, Kimimitsu; Takagi, Ritsuo; Maeda, Takeyasu

    2005-08-15

    The hypertrophic chondrocytes lack the ability to proliferate, thus permitting matrix mineralization as well as vascular invasion from the bone in both the mandibular condyle and the epiphyseal cartilage. This study attempted to verify whether the histological appearance of the hypertrophic chondrocytes is in a steady state during postnatal development of the mouse mandibular condyle. Type X collagen immunohistochemistry apparently distinguished the fibrous layer described previously as the "articular zone," "articular layer," and "resting zone" from the hypertrophic zone. Interestingly, the ratio of the type X collagen-positive hypertrophic zone in the entire condyle seemed higher in the early stages but decreased in the later stages. Some apparently compacted cells in the hypertrophic zone showed proliferating cell nuclear antigen (PCNA) immunoreaction, indicating the potential for cell proliferation at the early stages. As the mice matured, in contrast, they further enlarged and assumed typical features of hypertrophic chondrocytes. Apoptotic cells were also discernible in the hypertrophic zone at the early but not later stages. Consistent with morphological configurations of hypertrophic chondrocytes, immunoreactions for alkaline phosphatase, osteopontin, and type I collagen were prominent at the later stage, but not the early stage. Cartilaginous matrices demonstrated scattered patches of mineralization at the early stage, but increased in their volume and connectivity at the later stage. Thus, the spatial and temporal occurrence of these immunoreactions as well as apoptosis likely reflect the prematurity of hypertrophying cells at the early stage, and imply a physiological relevance during the early development of the mandibular condyles.

  4. The effect of treatment with functional appliance on a pathologic growth pattern of the condyle.

    Science.gov (United States)

    Melsen, B; Bjerregaard, J; Bundgaard, M

    1986-12-01

    Hemifacial microsomia causes asymmetry of the face frequently known to progress throughout the postnatal development if not submitted to any kind of treatment. According to the theoretic basis for treatment of hemifacial microsomia as presented by Harvold and associates, generation of the right muscle-bone interaction constitutes the necessary precondition for the bone apposition that produces facial symmetry. This theory was the basis for the treatment of three patients with abnormal condyles, one suffering from hemifacial microsomia, one patient with a unilateral condylar fracture followed by displacement and secondary resorption of the condyle, and one patient with bilateral loss of condylar cartilage as a result of trauma. The patients were treated with an activator a.m. Harvold, and the treatment results analyzed radiographically and clinically. The results demonstrated clearly that generation of an altered muscle balance is possible even though hemifacial microsomia patients suffer from absence of normal muscles--that is, normal functional matrix as well as absence of normal condyle--and that bone apposition required for establishment of symmetry can be achieved if the right microenvironment is established. It was, however, also obvious that treatment should be initiated as early as possible because the treatment result was dependent on both the timing and the cooperation of the patient.

  5. Assessment of condyle and glenoid fossa morphology using CBCT in South-East Asians.

    Directory of Open Access Journals (Sweden)

    May Al-koshab

    Full Text Available Proper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians.CBCT was used to assess 200 joints in 100 subjects (mean age, 30.5 years. i-CAT CBCT software and The Mimics 16.0 software were employed to measure the volume, metrical size, position of each condyle sample and the thickness of the roof of the glenoid fossa (RGF.No significant gender differences were noted in thickness of the RGF and condylar length; however condylar volume, width, height and the joint spaces were significantly greater among males. With regards to comparison of both TMJs, the means of condylar volume, width and length of the right TMJ were significantly higher, while the means of the left condylar height and thickness of RGF were higher. When comparing the condylar measurements and the thickness of RGF between the two ethnic groups, we found no significant difference for all measurements with exception of condylar height, which is higher among Chinese.The similarity in measurements for Malays and Chinese may be due to their common origin. This information can be clinically useful in establishing the diagnostic criteria for condylar volume, metrical size, and position in the Malaysian East Asians population.

  6. Surgical treatment of adult mandibular condylar fractures:a clinical analysis of 32 cases%成人下颌骨髁突骨折手术治疗32例临床分析

    Institute of Scientific and Technical Information of China (English)

    严颖彬; 穆洁; 张兰成; 刘浩; 王志兴; 张军; 沈军; 张萍

    2016-01-01

    Objective To investigate the effect of surgical treatment of adult mandibular condylar fractures (including intracapsular fracture). Methods Thirty-two patients (33 sides) with condylar fractures underwent open reduction and rigid fixation. Six patients with intracapsular condylar fractures were treated with two 18-mm positional screws through a preauricular approach. Six patients (7 sides) with condylar neck fractures were rigidly fixed by 1 mini-plate via a retromandibular transparotid approach. Twenty patients with subcondylar fractures were operated and fixed by two titanium plates using an angular approach. Results The mean follow-up period was 13.5 months, and the mean maximum mouth opening was 37.5 mm by the last visit. All patients acquired good occlusal relationship and mandibular symmetry. Seven patients (21.9%) experienced transient palsy of the branches of the facial nerve, and recovered completely after three months. One patient developed a salivary fistula, and healed after two weeks of gauze compression. No permanent deficit of any facial nerve branch was observed. No patient showed condylar head resorption. Conclusion Appropriate surgical approaches and fixation methods for different types of condylar fractures are the key factors to achieve reliable clinical results.%目的:探讨包括囊内骨折在内的成人下颌骨髁突骨折的手术疗效。方法32例33侧髁突骨折中,囊内骨折6例,采用耳前入路和2枚18 mm的长螺钉固定;髁颈骨折6例7侧,采用颌后穿腮腺入路及1块小型板固定;髁颈下骨折20例,采用环下颌角入路和2块接骨板固定。结果术后平均随访13.5个月,随访期末平均最大张口度37.5 mm。32例患者均获得良好的咬合关系和面部对称性。7例(21.9%)出现暂时性面神经瘫痪,术后3个月均完全恢复,1例出现涎漏,加压包扎后痊愈。无永久性面瘫、髁头吸收等严重并发症。结论对不同类型的髁突骨折

  7. [The relationship of nutritional status, body and mandibular bone mineral density, tooth loss and fracture risk (FRAX) in pre-and postmenopausal women with periodontitis].

    Science.gov (United States)

    Aguilera-Barreiro, de Los Angeles; Dávalos-Vázquez, Karla Fabiola; Jiménez-Méndez, Carolina; Jiménez-Mendoza, Daniel; Olivarez-Padrón, Luis Ángel; Rodríguez-García, Mario Enrique

    2014-06-01

    Introducción: Durante la menopausia existe aumento de peso y disminución de densidad mineral ósea (DMO) el cual se ha relacionado con enfermedad periodontal (incidencia entre 5 a 30%), de ahí que sea indispensable evaluar factores de riesgo relacionados con antropometría y DMO. Objetivo: Evaluar la relación entre el índice de masa corporal (IMC), complexión esquelética, circunferencia de cintura, pérdida dentaria, riesgo de fractura, DMO de columna, cadera, fémur y mandíbula en mujeres pre y postmenopáusicas con periodontitis. Sujetos y metodología: Se estudiaron 60 mujeres de 35-60 años, se estudiaron 4 grupos (n = 15): Grupo control: mujeres premenopáuscas sin periodontitis, Grupo experimental 1: mujeres premenopáusicas con periodontitis, Grupo experimental 2: mujeres postmenopáusicas sin periodontitis y Grupo experimental 3: mujeres postmenopáusicas con periodontitis. La periodontitis fue diagnosticada con sonda periodontal digital computarizada, la DMO de mandíbula por radiografía digital con conversión de rayos X, el número de dientes por radiografía panorámica digital. Se obtuvo: el IMC, la complexión esquelética, circunferencia de cintura, riesgo de fractura mediante el cuestionario FRAX. Resultados: Las variables con correlaciones negativas a periodontitis: peso, IMC y DMO mandibular con riesgo de fractura (P menopausia se relaciona con mayor edad, menor talla, DMO mandibular baja y menor número de piezas dentarias. Con mayor riesgo de fractura en mujeres: con bajo peso e IMC y DMO mandibular.

  8. A tomographic study of the condyle position in temporomandibular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sung Youn; Ryu, Young Kyu [Dept. of Oral Radiology, College of Dentistry, Yonsei University, Seoul (Korea, Republic of)

    1988-11-15

    The aim of this study was to determine whether T.M.J. tomographic examination yielded significant difference in condyle positions among asymptomatic, myalgia, derangement, and arthrosis group of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows: 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substance range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P< .05). Also that of left central section existed between derangement and myalgia group, and that of left medial section existed between derangement and myalgia groups (P< . 05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement and group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main symptom side, and only between derangement and myalgia groups in central section of contra-lateral sides (P< .05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia group (P< .05

  9. Congenital and acquired mandibular asymmetry: Mapping growth and remodeling in 3 dimensions

    Science.gov (United States)

    Solem, R. Christian; Ruellas, Antonio; Miller, Arthur; Kelly, Katherine; Ricks-Oddie, Joni L.; Cevidanes, Lucia

    2016-01-01

    Introduction Disordered craniofacial development frequently results in definitive facial asymmetries that can significantly impact a person's social and functional well-being. The mandible plays a prominent role in defining facial symmetry and, as an active region of growth, commonly acquires asymmetric features. Additionally, syndromic mandibular asymmetry characterizes craniofacial microsomia (CFM), the second most prevalent congenital craniofacial anomaly (1:3000 to 1:5000 live births) after cleft lip and palate. We hypothesized that asymmetric rates of mandibular growth occur in the context of syndromic and acquired facial asymmetries. Methods To test this hypothesis, a spherical harmonic-based shape correspondence algorithm was applied to quantify and characterize asymmetries in mandibular growth and remodeling in 3 groups during adolescence. Longitudinal time points were automatically registered, and regions of the condyle and posterior ramus were selected for growth quantification. The first group (n = 9) had a diagnosis of CFM, limited to Pruzansky-Kaban type I or IIA mandibular deformities. The second group (n = 10) consisted of subjects with asymmetric, nonsyndromic dentofacial asymmetry requiring surgical intervention. A control group (n = 10) of symmetric patients was selected for comparison. A linear mixed model was used for the statistical comparison of growth asymmetry between the groups. Results Initial mandibular shape and symmetry displayed distinct signatures in the 3 groups (P < 0.001), with the greatest asymmetries in the condyle and ramus. Similarly, mandibular growth had unique patterns in the groups. The dentofacial asymmetry group was characterized by significant asymmetry in condylar and posterior ramal remodeling with growth (P < 0.001). The CFM group was characterized by asymmetric growth of the posterior ramus (P < 0.001) but relatively symmetric growth of the condyles (P = 0.47). Conclusions Forms of CFM are characterized by active and

  10. Effect of three different core materials on the fracture resistance of endodontically treated deciduous mandibular second molars: an in vitro study.

    Science.gov (United States)

    Shah, Preetam; Gugwad, Sachin C; Bhat, Chetan; Lodaya, Rahul

    2012-01-01

    Endodontic treatment makes the tooth brittle due to loss of bulk of tooth structure, decrease in the moisture content of dentin and dentin elasticity. The following study was carried out to evaluate the effect of endodontic treatment on the fracture resistance of the tooth and reinforcing ability of three different core materials. The following study comprised of sample size of 30 deciduous second molars divided into control group (6) and test group (24). Access opening was done in 24 and 18th teeth with access opening were restored with three different core materials namely IRM (6), silver amalgam (6), GIC (6). All the 30 were subjected to fracture test using UTM (Universal testing machine)- Instron 95. Result showed a drastic reduction in the fracture resistance of the tooth on access opening (1/3rd) and out of the three core materials glass ionomer was shown to be the best core material giving the highest fracture registrance followed by silver amalgam and IRM.

  11. No differences in morphological characteristics between hyperplastic condyle and class III condyle.

    Science.gov (United States)

    Goulart, D R; Muñoz, P; Olate, S; de Moraes, M; Fariña, R

    2015-10-01

    The aim of this research was to compare the condylar morphology of patients with unilateral condylar hyperplasia (UCH) and patients with a class III skeletal relationship using cone beam computed tomography (CBCT). A prospective study was conducted on patients with facial asymmetry attending the division of oral and maxillofacial surgery of the study university in Chile. Fifteen patients with UCH and 15 with a class III skeletal relationship were selected. Linear measurements of the condylar processes were obtained at a scale of 1:1 using the software Ez3D Viewer Plus. Analysis of variance (ANOVA) and the paired t-test were used, considering Pclass III skeletal relationship showed no differences between the right and left sides; the morphology of their condyles was similar to the condyles with hyperplasia and presented statistical differences when compared with the non-hyperplastic condyles (one-way ANOVA, Pclass III skeletal relationship. These findings provide an insight into the possibility of some class III patients presenting bilateral condylar hyperplasia.

  12. Fracture of the styloid process associated with the mandible fracture

    Directory of Open Access Journals (Sweden)

    K N Dubey

    2013-01-01

    Full Text Available Fracture of the styloid process (SP of temporal bone is an uncommon injuries. Fracture of the SP can be associated with the facial injuries including mandible fracture. However, injury to the SP may be concealed and missed diagnosis may lead to the improper or various unnecessary treatments. A rare case of SP fracture associated with the ipsilateral mandibular fracture and also the diagnostic and management considerations of the SP fracture are discussed.

  13. Structural and mechanical properties of mandibular condylar bone.

    Science.gov (United States)

    van Eijden, T M G J; van der Helm, P N; van Ruijven, L J; Mulder, L

    2006-01-01

    The trabecular bone of the mandibular condyle is structurally anisotropic and heterogeneous. We hypothesized that its apparent elastic moduli are also anisotropic and heterogeneous, and depend on trabecular density and orientation. Eleven condyles were scanned with a micro-CT system. Volumes of interest were selected for the construction of finite element models. We simulated compressive and shear tests to determine the principal mechanical directions and the apparent elastic moduli. Compressive moduli were relatively large in directions acting in the sagittal plane, and small in the mediolateral direction. The degree of mechanical anisotropy ranged from 4.7 to 10.8. Shear moduli were largest in the sagittal plane and smallest in the transverse plane. The magnitudes of the moduli varied with the condylar region and were proportional to the bone volume fraction. Furthermore, principal mechanical direction correlated significantly with principal structural direction. It was concluded that variation in trabecular structure coincides with variation in apparent mechanical properties.

  14. Evaluation of Condylar Position after Orthognathic Surgery for Treatment of Class II Vertical Maxillary Excess and Mandibular Deficiency by Using Cone-Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    Reza Tabrizi

    2016-12-01

    Full Text Available Statement of the Problem: In orthognathic surgeries, proper condylar position is one of the most important factors in postoperative stability. Knowing the condylar movement after orthognathic surgery can help preventing postoperative instabilities. Purpose: The aim of this study was to evaluate the condylar positional changes after Le Fort I maxillary superior repositioning along with mandibular advancement by using cone beam computed tomography (CBCT. Materials and Method: This cross-sectional study was conducted on 22 subjects who had class II skeletal malocclusion along with vertical maxillary excess. Subjects underwent maxillary superior repositioning (Le Fort I osteotomy along with mandibular advancement. The CBCT images were taken a couple of days before the surgery (T0, and one month (T1 and 9 months (T2 after the surgery. The condyles positions were determined from the most superior point of the condyle to three distances including the deepest point of the glenoid fossa, the most anterior-inferior point of the articular eminence, and the most superior point of the external auditory meatus in the sagittal plane. Results: The mean mandibular advancement was 4.33±2.1 mm and the mean maxillary superior repositioning was 4.66±0.3 mm. The condyles displaced inferiorly, anteriorly, and laterally between T0 and T1. They were repositioned approximately in the initial position in T2. No correlation was observed between the mandibular and maxillary movement and the condylar positions. Conclusion: The condyles displaced in the inferior-anterior-lateral position one month after the bilateral sagittal split osteotomy for mandibular advancement in combination with the maxillary Le Fort I superior repositioning. It seems that the condyles adapted approximately in their initial position nine months after the surgeries. Keywords ● Mandible ● Condyle ● CBCT ● Sagittal Osteotomy ● Vertical Maxillary Excess

  15. FRACTURES OF THE MANDIBLE IN CHILDREN

    African Journals Online (AJOL)

    2001-11-11

    Nov 11, 2001 ... confirmed mandibular fractures seen in children who were treated at the Department of Oral ... fractures were due to sport injuries. Other causes were .... young children and to prevent temporomandibular joint ankylosis as a ...

  16. Fracture resistance and failure patterns of endodontically treated mandibular molars with and without glass fiber post in combination with a zirconia-ceramic crown

    NARCIS (Netherlands)

    Salameh, Z.; Ounsi, H.F.; Abou Shelib, M.N.M.; Sadig, W.; Ferrari, M.

    2008-01-01

    Objective: The aim of this study was to investigate the influence of a fiber post on the fracture mechanics of zirconia crowns inserted over endodontically treated teeth with different extent of coronal damage. Methods: Endodontically treated human molars with three types of coronal damage received

  17. Sex determination by mandibular ramus: A digital orthopantomographic study

    Directory of Open Access Journals (Sweden)

    K Samatha

    2016-01-01

    Full Text Available Aims and Objectives: (1 To determine the usefulness of mandibular ramus as an aid in sex determination. (2 To evaluate Anteroposterior | superioinferior angle of mandibular condyle. Materials and Methods: A retrospective study was conducted using orthopantomographs of 60 males and 60 females,which were taken using Kodak 8000C Digital Panoramic and Cephalometric System (73 kVp, 12 mA, 13.9 s. The age group ranged between 18 – 45 years. Mandibular ramus measurements were carried out using Master View 3.0 software. The measurements of the mandibular ramus will be subjected to Discriminant function analysis. Results: Maximum ramus breadth, Minimum ramus breadth, Condylar height, Projective height of ramus Coronoid height were calculated for both the sexes differently with the formula & analyzed with Discriminant function analysis using Fischer exact test. The P value was statistically significant with the P value < 0.05 for the following parameters Max. ramus breadth, Condylar height and Projective height of ramus. Conclusion: Mandibular ramus measurements can be a useful tool for gender determination.

  18. Novel three dimensional position analysis of the mandibular foramen in patients with skeletal class III mandibular prognathism

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Sang Hoon; Kim, Yeon Ho; Won, Yu Jin; Kim, Moon Key [Dept. of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang (Korea, Republic of)

    2016-06-15

    To analyze the relative position of the mandibular foramina (MnFs) in patients diagnosed with skeletal class III malocclusion. Computed tomography (CT) images were collected from 85 patients. The vertical lengths of each anatomic point from the five horizontal planes passing through the MnF were measured at the coronoid process, sigmoid notch, condyle, and the gonion. The distance from the anterior ramus point to the posterior ramus point on the five horizontal planes was designated the anteroposterior horizontal distance of the ramus for each plane. The perpendicular distance from each anterior ramus point to each vertical plane through the MnF was designated the horizontal distance from the anterior ramus to the Mn F. The horizontal and vertical positions were examined by regression analysis. Regression analysis showed the heights of the coronoid process, sigmoid notch, and condyle for the five horizontal planes were significantly related to the height of the MnF, with the highest significance associated with the MnF-mandibular plane (coefficients of determination (R2): 0.424, 0.597, and 0.604, respectively). The horizontal anteroposterior length of the ramus and the distance from the anterior ramus point to the MnF were significant by regression analysis. The relative position of the MnF was significantly related to the vertical heights of the sigmoid notch, coronoid process, and condyle as well as to the horizontal anteroposterior length of the ascending ramus. These findings should be clinically useful for patients with skeletal class III mandibular prognathism.

  19. Novel three-dimensional position analysis of the mandibular foramen in patients with skeletal class III mandibular prognathism

    Science.gov (United States)

    Kim, Yeon-Ho; Won, Yu-Jin; Kim, Moon-Key

    2016-01-01

    Purpose To analyze the relative position of the mandibular foramina (MnFs) in patients diagnosed with skeletal class III malocclusion. Materials and Methods Computed tomography (CT) images were collected from 85 patients. The vertical lengths of each anatomic point from the five horizontal planes passing through the MnF were measured at the coronoid process, sigmoid notch, condyle, and the gonion. The distance from the anterior ramus point to the posterior ramus point on the five horizontal planes was designated the anteroposterior horizontal distance of the ramus for each plane. The perpendicular distance from each anterior ramus point to each vertical plane through the MnF was designated the horizontal distance from the anterior ramus to the MnF. The horizontal and vertical positions were examined by regression analysis. Results Regression analysis showed the heights of the coronoid process, sigmoid notch, and condyle for the five horizontal planes were significantly related to the height of the MnF, with the highest significance associated with the MnF-mandibular plane (coefficients of determination (R2): 0.424, 0.597, and 0.604, respectively). The horizontal anteroposterior length of the ramus and the distance from the anterior ramus point to the MnF were significant by regression analysis. Conclusion The relative position of the MnF was significantly related to the vertical heights of the sigmoid notch, coronoid process, and condyle as well as to the horizontal anteroposterior length of the ascending ramus. These findings should be clinically useful for patients with skeletal class III mandibular prognathism. PMID:27358814

  20. Effects of the condylar process fracture on facial symmetry in rats submitted to protein undernutrition Efeitos da fratura do processo condilar na simetria facial em ratos submetidos à desnutrição protéica

    Directory of Open Access Journals (Sweden)

    Lucimar Rodrigues

    2011-04-01

    Full Text Available PURPOSE: To investigate the facial symmetry of rats submitted to experimental mandibular condyle fracture and with protein undernutrition (8% of protein by means of cephalometric measurements. METHODS: Forty-five adult Wistar rats were distributed in three groups: fracture group, submitted to condylar fracture with no changes in diet; undernourished fracture group, submitted to hypoproteic diet and condylar fracture; undernourished group, kept until the end of experiment, without condylar fracture. Displaced fractures of the right condyle were induced under general anesthesia. The specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. The values obtained were subjected to statistical analyses among the groups and between the sides in each group. RESULTS: There was significative decrease of the values of serum proteins and albumin in the undernourished fracture group. There was deviation of the median line of the mandible relative to the median line of the maxilla, significative to undernutrition fracture group, as well as asymmetry of the maxilla and mandible, in special in the final period of experiment. CONCLUSION: The mandibular condyle fracture in rats with proteic undernutrition induced an asymmetry of the mandible, also leading to consequences in the maxilla.OBJETIVO: Investigar a simetria facial de ratos submetidos à fratura experimental de côndilo mandibular e com desnutrição protéica (8% de proteína por meio de mensurações cefalométricas. MÉTODOS: 45 ratos Wistar adultos foram distribuídos em três grupos: grupo fraturado, submetido a fratura condilar sem alteração na dieta; grupo fraturado desnutrido, submetido a dieta hipoprotéica e fratura condilar; grupo desnutrido, mantido até o final do experimento, sem fratura condilar. Fraturas com desvio foram feitas no côndilo direito com anestesia geral. Os espécimes foram submetidos à incidência radiogr

  1. Class III malocclusion with maxillary deficiency, mandibular prognathism and facial asymmetry

    Science.gov (United States)

    Almeida, Guilherme de Araújo

    2016-01-01

    ABSTRACT This article reports the clinical case of a female patient with history of unsuccessful orthodontic treatment. She presented with Class III malocclusion, mandibular and maxillary constriction, anterior crossbite and facial asymmetry resulting from laterognathism triggered by hyperactivity of the condyle revealed by vertical elongation of the right mandibular ramus. Patient's treatment consisted of orthodontic mechanics and two orthognathic surgical interventions with satisfactory and stable outcomes. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), as part of the requirements for obtaining the BBO Diplomate title. PMID:27901236

  2. Class III malocclusion with maxillary deficiency, mandibular prognathism and facial asymmetry.

    Science.gov (United States)

    Almeida, Guilherme de Araújo

    2016-01-01

    This article reports the clinical case of a female patient with history of unsuccessful orthodontic treatment. She presented with Class III malocclusion, mandibular and maxillary constriction, anterior crossbite and facial asymmetry resulting from laterognathism triggered by hyperactivity of the condyle revealed by vertical elongation of the right mandibular ramus. Patient's treatment consisted of orthodontic mechanics and two orthognathic surgical interventions with satisfactory and stable outcomes. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), as part of the requirements for obtaining the BBO Diplomate title.

  3. Class III malocclusion with maxillary deficiency, mandibular prognathism and facial asymmetry

    Directory of Open Access Journals (Sweden)

    Guilherme de Araújo Almeida

    Full Text Available ABSTRACT This article reports the clinical case of a female patient with history of unsuccessful orthodontic treatment. She presented with Class III malocclusion, mandibular and maxillary constriction, anterior crossbite and facial asymmetry resulting from laterognathism triggered by hyperactivity of the condyle revealed by vertical elongation of the right mandibular ramus. Patient's treatment consisted of orthodontic mechanics and two orthognathic surgical interventions with satisfactory and stable outcomes. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO, as part of the requirements for obtaining the BBO Diplomate title.

  4. Mandibular trauma treatment: a comparison of two protocols

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Roccia, F.; Forouzanfar, T.

    2015-01-01

    Objectives:The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two c

  5. Mandibular trauma treatment: a comparison of two protocols

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Roccia, F.; Forouzanfar, T.

    2015-01-01

    Objectives:The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two c

  6. Three-dimensional cone-beam computed tomography for assessment of mandibular changes after orthognathic surgery

    Science.gov (United States)

    Cevidanes, Lucia H. S.; Bailey, L'Tanya J.; Tucker, Scott F.; Styner, Martin A.; Mol, Andre; Phillips, Ceib L.; Proffit, William R.; Turvey, Timothy

    2013-01-01

    Introduction The purpose of this study was to assess alterations in the 3-dimensional (3D) position of the mandibular rami and condyles in patients receiving either maxillary advancement and mandibular setback or maxillary surgery only. Methods High-resolution cone-beam computed tomography scans were taken of 21 patients before and after orthognathic surgery. Ten patients with various malocclusions underwent maxillary surgery only, and 11 Class III patients received maxillary advancement and mandibular setback. Presurgery and postsurgery 3D models were registered on the surface of the cranial base. A new tool was used for graphical overlay and 3D display with color maps to visually assess the locations and to quantify positional changes in the posterior border of the mandibular rami and condyles between superimposed models. Results The average displacements in condylar position were small—0.77 mm (SD, 0.12 mm) and 0.70 mm (SD, 0.08 mm)—for 2-jaw and 1-jaw surgeries, respectively (not significant, P >.05). All 2-jaw surgery patients had backward rotational displacements of the mandibular rami (mean, 1.98 mm; SD, 1.03 mm), with a maximum surface distance change of ≥2 mm in 8 of 11 subjects. For the 1-jaw surgery, all subjects had small backward rotational displacements of the mandibular rami (mean, 0.78 mm; SD, 0.25 mm), with only 1 subject having a maximum surface distance change ≥2 mm. The difference in mean backward rotational displacement was statistically significant (P <.01). Conclusions The visualization of 3D model superimposition clearly identified the location, magnitude, and direction of mandibular displacement. The 3D imaging allowed quantification of vertical, transverse, and anteroposterior ramus displacement that accompanied mandibular, but not maxillary only, surgery. PMID:17208105

  7. [Change in condylar and mandibular morphology in juvenile idiopathic arthritis: cone beam volumetric imaging].

    Science.gov (United States)

    Garagiola, Umberto; Mercatali, Lorenzo; Bellintani, Claudio; Fodor, Attila; Farronato, Giampietro; Lőrincz, Adám

    2013-03-01

    The aim of this study is to show the importance of Cone Beam Computerized Tomography to volumetrically quantify TMJ damage in patients with JIA, measuring condylar and mandibular real volumes. 34 children with temporomandibular involvement by Juvenile Idiopathic Arthritis were observed by Cone Beam Computerized Tomography. 4 were excluded because of several imaging noises. The mandible was isolated from others craniofacial structures; the whole mandibular volume and its components' volumes (condyle, ramus, hemibody, hemisymphysis on right side and on left side) has been calculated by a 3D volume rendering technique. The results show a highly significant statistical difference between affected side volumetric values versus normal side volumetric values above all on condyle region (P < 0.01), while they don't show any statistical differences between right side versus left side. The Cone Beam Computerized Tomography represents a huge improvement in understanding of the condyle and mandibular morphological changes, even in the early stages of the Juvenile Idiopathic Arthritis. The JIA can lead in children to temporomandibular joint damage with facial development and growth alterations.

  8. Changes in mandibular mobility after different procedures of orthognathic surgery.

    Science.gov (United States)

    Zimmer, B; Schwestka, R; Kubein-Meesenburg, D

    1992-06-01

    A prospective study including 63 adult Class II and Class III patients was carried out in order to examine short- and long-term effects of four different treatment methods on mandibular mobility. The patients were treated either (Group A, control-group) orthodontically alone or (Group B) by a LeFort I-osteotomy, a (Group C) mandibular advancement or (Group D) a two-jaw surgery/mandibular set-back. In the surgery-groups (B, C, and D) maximum opening, protrusion and lateral excursions were measured 2 days pre-operatively (T0), and 3, 8, 14.5, and 25.5 months post-operatively (T1-T4). In the control-group (A) at T0 and T4 was measured, only. Significantly differing effects of the four treatment methods on mandibular mobility were detected. (A) Orthodontic treatment alone, (B) maxillary advancement by LeFort I osteotomy, and (D) two-jaw surgery/mandibular set-back osteotomy did not influence mandibular mobility permanently. Temporary decreases in groups B and D (P less than or equal to 0.05) were observed, however. In contrast, permanent reductions after (C) mandibular advancement took place (P less than or equal to 0.001). Longitudinal survey showed that in all surgery groups recoveries were limited to a short period of 3-14.5 months, depending on the movement. Surprisingly, a closer similarity between the LeFort-I group (B) and the two-jaw surgery group (D), rather than between the sagittal-split groups (C and D), was seen indicating that the problem of reduced mobility after orthognathic surgery can be limited to Class II therapy. It was concluded that in Class III therapy, the application of rigid fixation in combination with a method of maintaining condyle-position, thereby dispensing with maxillomandibular fixation, prevents permanent reductions in mobility and guarantees a rapid recovery to pre-operative mobility levels.

  9. Quantitative Assessment of Radioisotope Uptake in Condyles by SPECT Bone Scintigraphy

    Directory of Open Access Journals (Sweden)

    Z. Dalili

    2006-03-01

    Full Text Available Statement of problem: Condylar hyperplasia of the mandible is a self limiting abnormality which can cause facial asymmetry, temporomandibular joint (TMJdysfunction and esthetic problems. Treatment planning is based on the results of isotope scanning, clinical findings and patient age. Single photon emission tomography(SPECT is considered to be a sensitive method in the calculation of condylar uptake differences.Purpose: The aim of this study was to determine the growth activity occurring in the mandibular condyles, and to devise an index of side-to-side differences in condylar activity in different individuals.Material and Methods: 38 patients, with an age range of 13 to 34 years, undergoing skeletal scintigraphy for a variety of conditions, were chosen for this study. 25 mci TC-99 was injected to all subjects in order to assess the difference between right (Rt andleft (Lt condylar uptake percentage and to calculate the Lt to Rt condylar uptake ratio.The normal index was determined.Results: The maximum amount of difference between the uptake of Rt and Lt condyles was 6.2 percent (Lt side and Rt side were 53.1 % and 46.9 %, respectively in the male patients and 5.7 percent in the female patients (Lt side and Rt side were 52.85 % and 47.15 %, respectively. The condylar activity difference and ratio of Lt to Rt condylar uptakes did not show a significant difference between the male and female groups.Conclusion: The difference between the growth activity of RT and LT normal TMJs was less than 6.2 percent.

  10. Mechanical properties of cancellous bone in the human mandibular condyle are anisotropic

    DEFF Research Database (Denmark)

    Giesen, EB; Ding, Ming; Dalstra, M;

    2001-01-01

    ). Archimedes' principle was applied to determine bone density parameters. The cancellous bone was in axial loading 3.4 times stiffer and 2.8 times stronger upon failure than in transverse loading. High coefficients of correlation were found among the various mechanical properties and between them...

  11. Comparison of doses received in the mandibular condyle, cochlea, and parotid gland in neuroaxial treatment

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Fernanda L.; Lima, Fabiana F. de; Vilela, Eudice, E-mail: fluoliveira@gmail.com [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil); Fo, Joao Antonio, E-mail: jaf@ufpe.br [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Departamento de Energia Nuclear

    2015-07-01

    Sensorineural hearing loss is a common side effect in patients who undergo radiotherapy for the treatment of cancer tumors in the head and neck. In fractioned doses of radiotherapy, in the majority of intracranial tumors, the cochlea is the most affected organ. In addition to the cochlea, the mandible and the parotid glands are also exposed to radiation, which commonly leads to Osteoradionecrosis of the mandible and Xerostomia. In the head and neck regions, this can be complicated by the semi-independence of the positioning in this region, as regards the rigid cranium, connected to the semi-rigid mandible, and successive levels of the upper cervical spine and thoracic spine, which can lead to uncertainty in rotation as well as in head-neck movements, both up and down and side to side. The present study performed an intercomparison of the doses applied through four radiotherapy planning techniques for the neuro axial regions of the cochlea, mandible, and parotid glands, considering the changes carried out in each planning technique, including the protective shield, the angulations gantry and the field size. The results obtained by applying the half beam and angled field techniques varied in the cochlea by an average of 113.8% from the prescribed dose, whereas when applying the angled field technique with and without the mobile gap, the results varied in 104.5%. In the mandible, the half beam and angled field techniques showed that the dose varied an average of 16.5%, while in the techniques with and without the mobile gap, the variation showed an average of 116.4%. These values were also received by the parotid glands, which overlap the mandible. It can therefore be concluded that the protection shields of the first two techniques were less efficient in protecting the mandible due to its modeling. (author)

  12. Chondrosarcoma of the mandibular condyle in a patient with Werner syndrome: a case report.

    Science.gov (United States)

    Goutzanis, Labros; Kalfarentzos, Evagelos F; Petsinis, Vassilis; Papadogeorgakis, Nick

    2013-10-01

    Werner syndrome, also called progeria of the adult and pangeria is a rare autosomal recessive disorder that affects connective tissue throughout the body. It is associated with premature ageing and an increased risk of cancer and other diseases. The mean survival for patients with Werner syndrome is 47 years. Death usually occurs when patients are aged 30-65 years because of atherosclerosis or malignant tumours. The purpose of this paper is to present a patient with Werner syndrome exhibiting a chondrosarcoma of the left temporomandibular joint and ramus. To the best of our knowledge this is the first case, of a Werner syndrome patient with an associated head and neck chondrosarcoma being reported. The diagnostic procedure followed and management of the patient are outlined in the paper as well.

  13. Morphometric Study of the Irradiation Effect on the Cartilage Formation in the Rat Mandibular Condyle

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Hwa; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1999-02-15

    This study was undertaken to quantitatively estimate the degree of the damage and recovery of the irradiated rat condylar cartilage using the Image Analyzer. Experimental animals were 16 male rats of the Sprague-Dawley strain at the age of 20 day irradiated with the dose of 10 Gy in their head and neck region. Four rats were sacrificed at the each of the following time intervals - 1, 4, 7 and 14 days, respectively. The same number of control group animals were sacrificed at the each age of 21, 24, 27 and 34 days, respectively. The specimens were stained with 0.5% toluidine blue and examined with light microscope. The condylar cartilage was divided into 4 zones; fibrous zone, proliferating zone, upper hypertrophic zone, and lower hypertrophic zone. And then, the proliferating zone was subdivided into 2 layers - upper and lower layer, and upper and lower hypertrophic zone were subdivided into three layers, respectively - upper, middle and lower layer. With the aid of Image Analyzer, morphometric analysis was performed. The thickness, the numerical density of cells, the cell area density, the extracellular matrix area density, the mean area of single cell, the mean area of extracellular matrix per single cell were measured and analysed. In the experimental group, the thickness of the fibrous zone was slightly increased and that of the proliferating zone and the upper and the lower hypertrophic zone was markedly decreased. With time, the thickness of the fibrous zone was gradually increased and that of the proliferating zone and the upper and the lower hypertrophic zone was steadily in the decreased state. The numerical density of cells of the proliferating zone was increased on post-irradiated 1 day, but decreased after post-irradiated 4 day, and that of the upper hypertrophic zone was decreased. The numerical density of cells of the lower hypertrophic zone was decreased in the early stage and then was decreased or not significantly different from that of the control group with time. In the experimental group, the cell area density of the fibrous zone and the proliferating zone was decreased in the early stage and then gradually increased or not significantly different from that of the control group with time. The cell area density of the upper and the lower hypertrophic zone was varied with time. The extracellular matrix area density value were totally opposite to the cell area density values. The mean area of single cell of the fibrous zone and the proliferating zone was decreased on post-irradiated 1 day, and increased after post-irradiated 4 day. The mean area of single cell of the upper hypertrophic zone was varied with each layer and time. In the experimental group, the mean area of extracellular matrix per single cell of the fibrous zone was not significantly different with control group, and that of the proliferating zone was decreased on post-irradiated 1 day, and increased after post-irradiated 4 day. The mean area of extracellular matrix per single cell of the lower hypertrophic zone was increased in the early stage, and that of upper hypertrophic zone was varied with each layer and time. The condylar cartilages of rats were affected by irradiation, but the changes were varied with each layer and time. By morphometric analysis, the changes of the cells of the condylar cartilage of irradiated rat could be calculated quantitatively.

  14. 下颌骨髁状突骨折56例疗效分析%Retrospective study of treatments for 56 condylar fractures

    Institute of Scientific and Technical Information of China (English)

    曲昌锋; 郭哲; 陆平; 周晓南; 汪崇

    2012-01-01

    [ Objective] To investigate the treatments and curative effects for different types of condylar fractures. [ Methods] There were 56 condylar fractures presented with expectant treatments, condylar removal, arthroplasty, rigid fixation and evaluated the clinical effects. [Results] The curative effects were satisfactory but some patients suffered with complications such as injury of facial nerve, limitation of mouth opening, ankylosis of temporo - mandibular joint and absorption of condyle. [ Conclusion ] Miniplate rigid fixation based on anatomical reduction is an effective procedure in treating condylar neck and subcondylar fractures. Post - mandibular approach could significantly reduce the probability of facial nerve injury. Ankylosis of temporo - mandibular joint could happen if the serious dislocation of articular disc and comminuted fractures of condyle head.%[目的]探讨不同类型髁状突骨折的治疗方法和临床效果.[方法]回顾性分析大连市中心医院56例髁状突骨折病例,分别采用保守治疗及髁状突摘除、关节成形和小型钛板坚固内固定,并评价其临床效果.[结果]随访47例,所有病例均一期愈合,无感染,无涎瘘.但部分病例出现面神经损伤(5例)、张口受限(3例)、颞下颌关节强直(1例)、髁状突吸收(2例)等并发症.[结论]切开复位及小型钛板坚固内固定是治疗髁颈和髁颈下骨折的有效方法,但应保留翼外肌附着.经颌后区入路可明显降低面神经损伤的几率.囊内粉碎性骨折和髁状突骨折伴关节盘明显移位如处理不当易发生颞下颌关节强直.

  15. Evaluation of Condylar Position after Orthognathic Surgery for Treatment of Class II Vertical Maxillary Excess and Mandibular Deficiency by Using Cone-Beam Computed Tomography

    Science.gov (United States)

    Tabrizi, Reza; Shahidi, Shoaleh; Bahramnejad, Emad; Arabion, Hamidreza

    2016-01-01

    Statement of the Problem: In orthognathic surgeries, proper condylar position is one of the most important factors in postoperative stability. Knowing the condylar movement after orthognathic surgery can help preventing postoperative instabilities. Purpose: The aim of this study was to evaluate the condylar positional changes after Le Fort I maxillary superior repositioning along with mandibular advancement by using cone beam computed tomography (CBCT). Materials and Method: This cross-sectional study was conducted on 22 subjects who had class II skeletal malocclusion along with vertical maxillary excess. Subjects underwent maxillary superior repositioning (Le Fort I osteotomy) along with mandibular advancement. The CBCT images were taken a couple of days before the surgery (T0), and one month (T1) and 9 months (T2) after the surgery. The condyles positions were determined from the most superior point of the condyle to three distances including the deepest point of the glenoid fossa, the most anterior-inferior point of the articular eminence, and the most superior point of the external auditory meatus in the sagittal plane. Results: The mean mandibular advancement was 4.33±2.1 mm and the mean maxillary superior repositioning was 4.66±0.3 mm. The condyles displaced inferiorly, anteriorly, and laterally between T0 and T1. They were repositioned approximately in the initial position in T2. No correlation was observed between the mandibular and maxillary movement and the condylar positions. Conclusion: The condyles displaced in the inferior-anterior-lateral position one month after the bilateral sagittal split osteotomy for mandibular advancement in combination with the maxillary Le Fort I superior repositioning. It seems that the condyles adapted approximately in their initial position nine months after the surgeries. PMID:27942547

  16. Transphyseal Distal Humerus Fracture.

    Science.gov (United States)

    Abzug, Joshua; Ho, Christine Ann; Ritzman, Todd F; Brighton, Brian

    2016-01-01

    Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal distal humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.

  17. Late reconstruction of condylar neck and head fractures.

    Science.gov (United States)

    Davis, Ben

    2013-11-01

    Condyle fractures are a common injury, but only a few of these injuries require immediate or late reconstruction. The complications that most frequently necessitate condylar reconstruction include proximal segment degeneration, malunion, and ankylosis. Costochondral grafts and total joint prostheses, both stock and custom, remain the most common methods of reconstruction. Reconstruction plates with condylar extensions should only be used temporarily as an unacceptable number cause serious complications. Distraction osteogenesis may have an occasional role in reconstructing the posttraumatic condyle.

  18. Preservation of condyle and disc in the surgical treatment of type III temporomandibular joint ankylosis: a long-term follow-up clinical study of 111 joints.

    Science.gov (United States)

    Jakhar, S K; Agarwal, M; Gupta, D K; Tiwari, A D

    2013-06-01

    The purpose of this study was to establish the role of retaining the condyle and disc in the treatment of type III ankylosis, by clinical and computed tomography (CT) evaluation. A total of 90 patients with type III ankylosis met the inclusion criteria; 42 patients had left temporomandibular joint (TMJ) ankylosis, 27 patients had right TMJ ankylosis, and 21 had bilateral TMJ ankylosis, thus a total 111 joints were treated. Considerable improvements in mandibular movement and maximum mouth opening were noted in all patients. At the end of a minimum follow-up of 2 years, the mean inter-incisal mouth opening was 30.7 mm. Postoperative occlusion was normal in all patients, and open bite did not occur in any case because the ramus height was maintained through preservation of the pseudo-joint. Only three patients had recurrence of ankylosis, which was due to a lack of postoperative physiotherapy. The advantages of condyle and disc preservation in type III ankylosis are: (1) surgery is relatively safe; (2) the disc helps to prevent recurrence of ankylosis; (3) the existing ramus height is maintained; (4) the growth site is preserved; and (5) there is no need to reconstruct the joint with autogenous or alloplastic material. It is recommended that the disc and condyle are preserved in type III TMJ ankylosis. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Manual reduction of articular disc after traumatic extraction of mandibular third molar: a case report

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    Rubens Camino Junior

    2015-10-01

    Full Text Available Introduction: Disc displacement without reduction with limited opening is an intracapsular biomechanical disorder involving the condyle-disc complex. With the mouth closed, the disc is in an anterior position in relation to the condylar head and does not reduce with mouth opening. This disorder is associated with persistent limited mandibular opening.Case report:The patient presented severe limitation to fully open the mouth, interfering in her ability to eat. Clinical examination also revealed maximum assisted jaw opening (passive stretch with less than 40 mm of maximum interincisal opening. Magnetic resonance imaging was the method of choice to identify the temporomandibular disorders.Conclusion: By means of reporting this rare case of anterior disc displacement without reduction with limited opening, after traumatic extraction of a mandibular third molar, in which manual reduction of temporomandibular joint articular disc was performed, it was possible to prove that this technique is effective in the prompt restoration of mandibular movements.

  20. Hoffa fracture associated with ipsilateral femoral shaft fracture: clinical feature and treatment.

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    Gong, Yu-Bao; Li, Qing-Song; Yang, Chen; Li, Shu-Qiang; Liu, Jian-Guo; Qi, Xin

    2011-01-01

    Hoffa fracture associated with ipsilateral femoral shaft fracture is very rare. Three cases of this rare type of injury were retrospectively reviewed. The sites of femoral shaft fractures and Hoffa fractures were documented. All femoral shaft fractures were managed with internal fixation. The rate of misdiagnosis for the Hoffa fractures was documented. Functions of the affected knees were evaluated according to the modified Hospital for Special Surgery (HSS) scores at two years follow-up. Femoral fractures were either transverse or composite in all three cases. Ipsilateral Hoffa fractures occurred at medial condyle in two cases, and lateral condyle in one case. Only one Hoffa fracture was identified preoperatively. All the femoral shaft fractures healed uneventfully. In the patient whose Hoffa fracture was correctly diagnosed, the modified HSS score was 94. In another patient, whose Hoffa fracture was treated by a second operation, the modified HSS score was 93. And in the third case, who refused additional operation for the Hoffa fracture, the modified HSS score was only 70. Conclusively femoral shaft fracture can be associated with ipsilateral Hoffa fracture, especially in motorcycle accident. This type of injury is very rare and misdiagnosis is common.

  1. Hoffa fracture associated with ipsilateral femoral shaft fracture: clinical feature and treatment

    Institute of Scientific and Technical Information of China (English)

    GONG Yu-bao; LI Qing-song; YANG Chen; LI Shu-qiang; LIU Jian-guo; QI Xin

    2011-01-01

    Hoffa fracture associated with ipsilateral femoral shaft fracture is very rare.Three cases of this rare type of injury were retrospectively reviewed.The sites of femoral shaft fractures and Hoffa fractures were documented.All femoral shaft fractures were managed with internal fixation.The rate of misdiagnosis for the Hoffa fractures was documented.Functions of the affected knees were evaluated according to the modified Hospital for Special Surgery (HSS) scores at two years follow-up.Femoral fractures were either transverse or composite in all three cases.Ipsilateral Hoffa fractures occurred at medial condyle in two cases,and lateral condyle in one case.Only one Hoffa fracture was identified preoperatively.All the femoral shaft fractures healed uneventfully.In the patient whose Hoffa fracture was correctly diagnosed,the modified HSS score was 94.In another patient,whose Hoffa fracture was treated by a second operation,the modified HSS score was 93.And in the third case,who refused additional operation for the Hoffa fracture,the modified HSS score was only 70.Conclusively femoral shaft fracture can be associated with ipsilateral Hoffa fracture,especially in motorcycle accident.This type of injury is very rare and misdiagnosis is common.

  2. Evaluation of skeletal and dental age using third molar calcification, condylar height and length of the mandibular body

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    Sunil Gupta Kedarisetty

    2015-01-01

    Full Text Available Aim: To identify the most reliable method for age estimation among three variables, that is, condylar height, length of mandibular body and third molar calcification by Demirjian′s method. Materials and Methods: Orthopantomograms and lateral cephalograms of 60 patients with equal gender ratio were included in the study, among each gender 15 subjects were below 18 years and 15 subjects were above 18 years. Lateral cephalograms were traced, height of condyle and mandibular body are measured manually on the tracing paper, OPG′s were observed on radiographic illuminator and maturity score of third molar calcification was noted according to Demirjian′s method. All the measurements were subjected to statistical analysis. Results: The results obtained are of no significant difference between estimated age and actual age with all three parameters (P > 0.9780 condylar height, P > 0.9515 length of mandibular body, P > 0.8611 third molar calcification. Among these three, length of mandibular body shows least standard error test (i.e. 0.188. Conclusion: Although all three parameters can be used for age estimation, length of mandibular body is more reliable followed by height of condyle and third molar calcification.

  3. A comparative study of the skeletal morphology of the temporo-mandibular joint of children and adults

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    Meng F

    2008-01-01

    Full Text Available Background: The skeletal morphology of the temporo-mandibular joint (TMJ is constantly remodeled. Aims and Objectives: A comparative study was undertaken to determine and characterize the differences in the skeletal morphology of TMJ of children and adults. Materials and Methods: The study was conducted on 30 children cadavers and 30 adult volunteers. Parameters that could reflect TMJ skeletal morphology were measured with a new technology combining helical computed tomography (CT scan with multi-planar reformation (MPR imaging. Results: Significant differences between children cadavers and adults were found in the following parameters ( P < 0.05: Condylar axis inclination, smallest area of condylar neck/largest area of condylar process, inclination of anterior slope in inner, middle, and outer one-third of condyle, anteroposterior/mediolateral dimension of condyle, length of anterior slope/posterior slope in inner and middle one-third of condyle, anteroposterior dimension of condyle/glenoid fossa, mediolateral dimension of condyle/glenoid fossa, inclination of anterior slope of glenoid fossa, depth of glenoid fossa, and anteroposterior/mediolateral dimension of glenoid fossa. Conclusion: There are significant differences of TMJ skeletal morphology between children and adults.

  4. Transmigration of mandibular second premolar in a patient with cleft lip and palate: case report

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    Daniel Berretta Moreira Alves

    2008-10-01

    Full Text Available Disturbances involving abnormalities in tooth eruption are named ectopia. Transmigration is the name assigned to ectopia in the presence of teeth in areas distant from the alveolar process. Initial angulation of the tooth bud of the second premolar and premature loss of permanent mandibular 1st molars can influence the distal migration of the second premolar. Some studies have observed that ectopic teeth can be found in a variety of places around the oral cavity and also in other areas of the human body. There are records of teeth in the maxillary sinus, mandibular condyle, coronoid process, mandibular angle, orbit, palate, mentum and also the skin. The prevalence of tooth abnormalities is higher in children with cleft lip and palate compared to children without clefts. This paper presents a case report of migration of the mandibular left second premolar in a patient attending the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC/USP, Brazil. Migration of the mandibular left 2nd premolar was confirmed by 8 panoramic and 1 periapical radiographs obtained during patient's treatment between 1978 and 2002, which were available in the files of the Department of Dental Radiology of HRAC/USP. It can be assumed that distal migration of the mandibular left 2nd premolar is not associated with presence of cleft lip and palate; observation of these two events in a same patient is rare, since no similar reported cases were found in the literature.

  5. RESEARCH OF BASIFACIAL CONTOURING SCULPTURE BY MANDIBULAR ANGLE OSTECTOMY

    Institute of Scientific and Technical Information of China (English)

    FANG Jian-lin; DAI Chuan-chang; ZHU Guo-xian; ZHANG Ying; JIN Yu-qing; WANG Wei; QI Chuan-liang

    2006-01-01

    Objective Mandibular angle ostectomy is usually applied to the facial contouring sculpture.We evaluated the various techniques in order to enhance the precision and avoid unnecessary damage. Methods Before operation the area and quantity resected bone were designed according to facial measurement, mandible pantomography and orthophoria and lateral localized radiograph of skull. The Incises of mandibular angle ostectomy included intraoral, retroauricular or intraoral associated with retroauricular. Howerer, the sagittal resection of mandible outer table was necessary in all intraoral incise. Results Single mandibular angle ostectomy was not satisfactory for the patients having mandible hypertrophy with over-width basifacial contouring. Mandibular angle ostectomy combined with the sagittal resection of outer table of mandibular angle were required. Good symmetry and ap pearance were gained in 206 cases. One case had facial paralysis. Two patients occured mandibular fracture during the operation. Three cases complicated angled deformity at mandible body. Conclusion Reduction mandibuloplasty should be selected depends on varied types of mandibular angle hypertrophy before operation.

  6. 颌后入路治疗髁突颈部骨折%Retromandibular Approach for Condylar Neck Fracture Reduction

    Institute of Scientific and Technical Information of China (English)

    马旭亮; 王超

    2014-01-01

    目的:探讨颌后入路治疗下颌骨髁突颈骨折的治疗方法及效果。方法:对23例单侧成人下颌骨中低位髁突颈骨折患者,经颌后入路,术中保护腮腺及面神经,行切开解剖复位坚强内固定术。结果:23例患者均取得良好解剖复位,无1例出现涎瘘,无1例出现面神经麻痹,咬合关系恢复良好,通过早期锻炼张口,均能恢复术前张口度,无关节强直出现。结论:颌后入路治疗下颌骨中低位髁突颈骨折,有术野暴露充分、操作方便、有效保护面神经及腮腺等优点。%Objective: To discuss the beneficiaries of a novel retromandibular approach for mandibular condyle neck fracture reduction. Methods:23 patients were consisted in this study. Operative procedures without injury of parotid gland and facial nerve. Open anatomic reduction and rigid internal fixation were retained. Results: All 23 cases achieved good anatomic reduction, without occurrence of salivary fistula, facial palsy, and ankylosis. Occlusal relationship was in good recovery, and degree of mouth opening restored to preoperative level. Conclusion: Retromandibular approach is conve-nient and effective in condyle neck fracture reduction.

  7. Do the changes in muscle mass, muscle direction, and rotations of the condyles that occur after sagittal split advancement osteotomies play a role in the aetiology of progressive condylar resorption?

    Science.gov (United States)

    Dicker, G J; Castelijns, J A; Tuinzing, D B; Stoelinga, P J W

    2015-05-01

    Changes in cross-sectional area (CSA), volume (indicating muscle strength), and direction of the masseter and medial pterygoid muscles after surgical mandibular advancement were measured, along with the rotation of the condyles after bilateral sagittal split osteotomies (BSSOs) to advance the mandible. Measurements were done on magnetic resonance images obtained before and 2 years after surgery. CSA and volume were measured in five short-face and seven long-face patients (five males, seven females). Muscle direction was calculated in eight short-face and eight long-face patients (eight males, eight females). Short-face patients underwent BSSO only; long-face patients underwent combined BSSO and Le Fort I osteotomies. The CSA and volume decreased significantly (mean 18%) in all patients after surgery. The postoperative muscle direction was significantly more vertical (9°) in long-face patients. Rotations of the proximal segments (condyles) were minimal after 2 years. The results of this study showed that, after BSSO advancement surgery, changes in the masseter and medial pterygoid muscles are not likely to cause increased pressure on the condyles and nor are the minimal rotations of the condyles. It is concluded that neither increased muscle traction nor condylar rotations can be held responsible for progressive condylar resorption after advancement BSSO.

  8. Fraturas do côndilo mandibular: análise clínica retrospectiva das indicações e do tratamento Evaluation of condylar fractures treatment

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    Eduardo Fausto de Andrade Filho

    2003-01-01

    Full Text Available OBJETIVO: Analisamos 40 pacientes com fraturas no processo condilar da mandíbula, tratados pelo método fechado (bloqueio maxilomandibular ou conservador ou aberto (redução direta no foco de fratura com ou sem osteossíntese, no período de janeiro de 1993 a janeiro de 1999 no Setor de Trauma Maxilofacial da Disciplina de Cirurgia Plástica da UNIFESP-EPM. MÉTODO: Avaliamos clinicamente estes pacientes através da palpação da articulação têmporomandibular, observação da simetria mandibular, oclusão dentária, desvio à abertura de boca e abertura máxima interincisal; além de questionário sobre queixas na ATM, disfunção mastigatória e satisfação do tratamento realizado. RESULTADOS: Foi encontrado um índice de resultados satisfatórios de no mínimo 70% nos pacientes submetidos ao bloqueio. No método conservador esse índice foi de no mínimo 42,9%, e nos submetidos à redução com fio de aço de no mínimo 28,6%, sem diferença significante entre os diversos exames clínicos. O índice de dor na ATM entre os pacientes tratados pelo método fechado foi de 3,7% e pelo aberto de 15,4%. A disfunção mastigatória foi de 22,2% no método fechado e 15,4% no aberto; sendo que foram encontrados somente 7,1% de pacientes insatisfeitos com o tratamento fechado. Não houve diferença significante entre os resultados dos métodos. CONCLUSÃO: Os métodos fechado (BMM e conservador e aberto, com redução e osteossíntese com fio de aço, trouxeram resultados clínicos satisfatórios em avaliação superior a seis meses. Concluiu-se também que não há diferença entre os resultados de queixas após o tratamento aberto ou fechado, na opinião dos pacientes.BACKGROUND: We analysed 40 patients with mandibular condylar process fractures, treated through the closed (intermaxilary fixation or conservatively or open methods (wire internal fixation,titanium miniplates, bone reduction or articular exploration, from January 1993 to January

  9. Accuracy of perioperative mandibular positions in orthognathic surgery.

    Science.gov (United States)

    Borba, A M; Ribeiro-Junior, O; Brozoski, M A; Cé, P S; Espinosa, M M; Deboni, M C Z; Miloro, M; Naclério-Homem, M G

    2014-08-01

    Mandibular position is an important parameter used for the diagnosis of dentofacial deformities, as well as for orthognathic surgery planning and execution. Centric relation (anterior and superior relationship of the mandibular condyles interposed by the thinnest portion of their disks against the articular eminencies), centric occlusion (when lower teeth contact upper teeth at centric relation), and maximal intercuspation (complete interdigitation of lower and upper teeth) are not often addressed as factors that influence the results of orthognathic surgery, although these relationships are critical to ensure accuracy during the surgery. The present study assessed occlusal measurements taken before and after the induction of general anaesthesia from consecutive orthognathic surgery subjects. The variables assessed included the differences between these occlusal measurements, patient age, gender, type of deformity, and type of proposed orthognathic surgical procedure. The results demonstrated statistically significant differences for mandibular retrusion from maximal intercuspation to centric occlusion position, whereas the mandible appeared not to change significantly from centric occlusion after the induction of general anaesthesia. Patient age and the type of deformity appeared to influence the results. While in most instances centric occlusion can be adequately reproduced under general anaesthesia, for some specific orthognathic cases more accurate results might be obtained if the mandible-first sequence is used.

  10. Occipital condyle syndrome secondary to bone metastases from rectal cancer.

    Science.gov (United States)

    Marruecos, J; Conill, C; Valduvieco, I; Vargas, M; Berenguer, J; Maurel, J

    2008-01-01

    Skull-base metastases are very unfrequent. Occipital condyle syndrome (OCS) is usually underdiagnosed. Until now few cases have been reported in the literature. We present a 71-year-old woman with metastatic rectum adenocarcinoma, with right occipital headache and ipsilateral hypoglossal palsy, diagnosed by computed tomography and magnetic resonance imaging of OCS due to a skull-base metastasis and treated with radiation therapy.

  11. Temporomandibular joint forces measured at the condyle of Macaca arctoides.

    Science.gov (United States)

    Boyd, R L; Gibbs, C H; Mahan, P E; Richmond, A F; Laskin, J L

    1990-06-01

    Forces were measured at the articular surface of the temporomandibular joint (TMJ) condyle in two stump-tail monkeys (Macaca arctoides) during chewing, incisal biting, and drinking and also during aggressive behaviors. Force was measured with a thin piezoelectric foil transducer, which was cemented over the anterior and superior surfaces of the condyle. Wires from the upper and lower surfaces of the foil were insulated between two layers of Teflon tape and run subcutaneously to a telemetry unit, which was implanted in the upper back. Force applied across the foil by the condyle was detected by the telemetry unit and transmitted to an FM radio receiver outside the animal. The FM signals were received and demodulated, and a signal proportional to the force applied between the condyle and the TMJ fossa was displayed on a chart recorder. Data were collected over an 8-day period. The animals were not constrained. The TMJ was found to be load bearing. The greatest force of 39.0 lb (17.7 kg) was measured during feisty vocal aggression. Forces ranged as high as 34.5 lb (15.7 kg) during chewing and 28.5 lb (13.0 kg) during incisal biting. Forces were greater on the working (food) side than on the nonworking (balancing) side by average ratios of 1.4 to 2.6. A large unilateral interference at the most distal molar greatly disturbed chewing. It reduced TMJ forces by 50% or more, and the monkey refused to chew on the side opposite the interference.

  12. Radiographic cephalometry analysis of condylar position after bimaxillary osteotomy in patients with mandibular prognathism

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    Miković Nikola D.

    2016-01-01

    Full Text Available Background/Aim. Postoperative condylar position is a substantial concern in surgical correction of mandibular prognathism. Orthognathic surgery may change condylar position and this is considered a contributing factor for early skeletal relapse and the induction of temporomandibular disorders. The purpose of this study was to evaluate changes in condylar position, and to correlate angular skeletal measurements following bimaxillary surgery. Methods. On profile teleradiographs of 21 patients with mandibular angular and linear parametres, the changes in condylar position, were measured during preoperative orthodontic treatment and 6 months after the surgical treatment. Results. A statistically significant difference in values between the groups was found. The most distal point on the head of condyle point (DI moved backward for 1.38 mm (p = 0.02, and the point of center of collum mandibulae point (DC moved backward for 1.52 mm (p = 0.007. The amount of upward movement of the point DI was 1.62 mm (p = 0.04. Conclusion. In the patients with mandibular prognathism, the condyles tend to migrate upward and forward six months after bimaxillary surgery.

  13. Morphometric evaluation of condylar cartilage of growing rats in response to mandibular retractive forces

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    Milena Peixoto Nogueira de Sá

    2013-08-01

    Full Text Available INTRODUCTION: The mandibular condylar surface is made up of four layers, i.e., an external layer composed of dense connective tissue, followed by a layer of undifferentiated cells, hyaline cartilage and bone. Few studies have demonstrated the behavior of the condylar cartilage when the mandible is positioned posteriorly, as in treatments for correcting functional Class III malocclusion. OBJECTIVE: The aim of this study was to assess the morphologic and histological aspects of rat condyles in response to posterior positioning of the mandible. METHODS: Thirty five-week-old male Wistar rats were selected and randomly divided into two groups: A control group (C and an experimental group (E which received devices for inducing mandibular retrusion. The animals were euthanized at time intervals of 7, 21 and 30 days after the experiment had began. For histological analysis, total condylar thickness was measured, including the proliferative, hyaline and hypertrophic layers, as well as each layer separately, totaling 30 measurements for each parameter of each animal. RESULTS: The greatest difference in cartilage thickness was observed in 21 days, although different levels were observed in the other periods. Group E showed an increase of 39.46% in the total layer, reflected by increases in the thickness of the hypertrophic (42.24%, hyaline (46.92% and proliferative (17.70% layers. CONCLUSIONS: Posteriorly repositioning the mandible produced a series of histological and morphological responses in the condyle, suggesting condylar and mandibular adaptation in rats.

  14. Morphometric evaluation of condylar cartilage of growing rats in response to mandibular retractive forces.

    Science.gov (United States)

    de Sá, Milena Peixoto Nogueira; Zanoni, Jacqueline Nelisis; de Salles, Carlos Luiz Fernandes; de Souza, Fabrício Dias; Suga, Uhana Seifert Guimarães; Terada, Raquel Sano Suga

    2013-01-01

    The mandibular condylar surface is made up of four layers, i.e., an external layer composed of dense connective tissue, followed by a layer of undifferentiated cells, hyaline cartilage and bone. Few studies have demonstrated the behavior of the condylar cartilage when the mandible is positioned posteriorly, as in treatments for correcting functional Class III malocclusion. The aim of this study was to assess the morphologic and histological aspects of rat condyles in response to posterior positioning of the mandible. Thirty five-week-old male Wistar rats were selected and randomly divided into two groups: A control group (C) and an experimental group (E) which received devices for inducing mandibular retrusion. The animals were euthanized at time intervals of 7, 21 and 30 days after the experiment had began. For histological analysis, total condylar thickness was measured, including the proliferative, hyaline and hypertrophic layers, as well as each layer separately, totaling 30 measurements for each parameter of each animal. The greatest difference in cartilage thickness was observed in 21 days, although different levels were observed in the other periods. Group E showed an increase of 39.46% in the total layer, reflected by increases in the thickness of the hypertrophic (42.24%), hyaline (46.92%) and proliferative (17.70%) layers. Posteriorly repositioning the mandible produced a series of histological and morphological responses in the condyle, suggesting condylar and mandibular adaptation in rats.

  15. Fractura patológica de la mandíbula asociada a quiste radicular: Reporte de 3 casos clínicos Mandibular pathologic fracture associated with radicular cyst: Report of three clinical cases

    OpenAIRE

    Bouguila, J.; L. Córdova Jara; I. Zairi; A. Adouani

    2008-01-01

    Introducción. El quiste radicular es el quiste más común de los maxilares. Su tamaño puede variar desde una lesión que abarca el proceso alveolar hasta uno extenso que oblitera el espacio antral maxilar o causa una fractura patológica mandibular. Reporte de casos. Se reportan tres casos con fractura patológica mandibular asociados a quiste radicular ocurridos después de trauma facial. El diagnóstico fue sugerido por un estudio clínico, radiografía panorámica y confirmado por el estudio histop...

  16. [Osteochondritis dissecans of the femoral condyles: report of 892 cases].

    Science.gov (United States)

    Lefort, G; Moyen, B; Beaufils, P; de Billy, B; Breda, R; Cadilhac, C; Clavert, J-M; Djian, P; Fenoll, B; Giacomelli, M-C; Gicquel, P; Gicquel-Schlemmer, B; Journeau, P; Karger, C; Laptoiu, D; Lefort, G; Mainard-Simard, L; Moyen, B; Negreanu, I; Prové, S; Robert, H; Thaunat, M; Versier, G

    2006-09-01

    Osteochondritis rarely involves the femoral condyles. Discovery in this localization raises several questions concerning the nature of the articular cartilage, the potential for spontaneous healing, and, in the event of a free fragment, the outcome after its loss or repair. This multicentric study included 892 pediatric and adult cases, the cutoff between two series being defined by fusion of the inferior growth plate. We excluded medical or surgical osteochondritis, cases involving the patella, osteochondral fractures, juvenile polyosteochondrosis, adult osteonecrosis, and osteochondritis beginning after the age of 50 years. Mean age at diagnosis was 16.5 years. Mean age at treatment onset was 22 years. Pain was the predominant symptom. 80% of cases were unilateral and 70% involved the medial condyle. The anatomic lesions were different in adults, showing more advanced degradation. At diagnosis, Bedouelle stages Ia and IIb constituted 80% of the cases observed among children while in adults, 66% were Bedouelle stages IIb to IV. Outcome was very good for the majority of children with Hughston clinical stage 4 while half of the x-rays were Hughston stage 3 and 4. There were thus a large percentage of children with abnormal xrays whose disease history was not yet terminated. In the adult series, the percentages of Hughston 3 and 4 was about the same as clinically. The x-rays were rarely perfectly normal since half of the clinical stage 3 patients were noted in stage 4. An abnormal x-ray with a very good clinical presentation was observed in a very large proportion of patients. It is difficult to interpret the plain x-ray and identify patients with a potentially unfavorable prognosis. We defined three radiographic classes: defect, nodule and empty notch. The Bedouelle classification uses information from all available explorations, particularly MRI and arthroscopy. Numerous therapeutic methods are used. Interruption of sports activities is the first intention

  17. Influence of the lateral pterygoid muscle on the growth of the mandibular condilar cartilage

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    Juan G. Quirós

    2013-01-01

    Full Text Available At the end of the last century, a model to explain clinical observations related to the mandibular growth was developed. According to it, the lateral pterigoid muscle (LPM was one of the main modulators of the differentiation of mesenquimal cells inside the condyle to condroblasts or osteoblasts, and therefore of the growth of the mandibular condilar cartilage (CCM. The main components of the model were the humoral and the mechanical. Nowadays, the humoral would include growth factors such as IGF-I, FGF-2 and VEGF, which seem to be involved in mandibular growth. Since skeletal muscle can secrete these growth factors, there is a possibility that LPM modulates the growth of CCM by a paracrine or endocrine mechanism. The mechanical component derived from the observations that both the blood flow inside the temporomandibular joint (ATM and the action of the retrodiscal pad on the growth of the CCM, depend, in part, on the contractile activity of the LPM. Despite the fact that there are some results suggesting hat LPM is activated under conditions of mandibular protrusion, there is no full agreement on whether this can stimulate the growth of CCM. In this review, the contributions and limitations of the works related to mandibular growth are discussed and a model which integrates the available information to explain the role of the LPM in the growth of the CCM is proposed.

  18. Early diagnostic evaluation of mandibular symmetry using orthopantomogram

    Directory of Open Access Journals (Sweden)

    Francesca Silvestrini-Biavati

    2014-01-01

    Full Text Available Aims: The aim of this research was to complete Habets′s method on orthopantomogram, in order to measure mandibular symmetry horizontally and diagonally in mixed dentition as the first diagnostic evaluation. Settings and Design: Mixed dentition subjects were consecutively selected according to skeletal maturity. Materials and Methods: Inclusion criteria were: Mixed dentition, cervical vertebral stages 1-2, Class II or Class III malocclusions, with or without unilateral posterior cross-bite. Fourteen subjects with cross-bite (mean age 8 y, 9 m cross group (CG and 14 subjects with normal transverse occlusion (mean age 8y, 6m non-cross group (NCG were selected. Nine measurements were determined. An asymmetry index was performed for all linear variables. Statistical Analysis Used: NCG patients′ data were compared with CG data using parametric t-tests. Probabilities of <0.05 were accepted as significant. Results: In CG, comparing right and left side, single values showed no significant differences up to 6% (twice if compared to the 3% threshold value. T-tests showed statistically significant differences between the groups for ramus + condyle height (index 2.5% vs 4.5%, P = 0.04, condylar height (index 3.7% vs 6.6%, P = 0.02 and mandibular length (index 1.4% vs 2.3%, P = 0.04. Overall CG group was more asymmetrical than NCG. Conclusions: In mixed dentition (CS1-2, a first appraisal of mandibular symmetry may be performed on orthopantomogram utilizing this modified Habets′s method. This tracing method provides an early evaluation about mandibular symmetry and is able to show slight asymmetries in mixed dentition thereby reducing the number of cone beam computed tomograms performed.

  19. Jaw fractures in children.

    Science.gov (United States)

    Kotilainen, R; Kärjä, J; Kullaa-Mikkonen, A

    1990-03-01

    From a total of 350 jaw fractures treated in 1980-1984 at Kuopio University Central Hospital, 20% were in children. These injuries were evaluated retrospectively regarding age, sex, incidence and etiology. Forty-five of the patients were boys and 25 girls. The frequency of maxillary and mandibular fractures in 70 young patients was 28.6%. The most common type of bone fractures was fracture of the alveolar process, which was prevalent in persons with mixed dentition. Before the age of 7 years, falls from height were the common causes of jaw fractures. The major cause of the jaw fractures in children from 7 to 15 years old was road accidents (47.1%), especially in boys. Most of these were cycling accidents, only a few patients were victims of automobile accidents. In addition, about one third (25.7%) of the patients were treated in the hospital because of multiple injuries to other organs.

  20. Familial aggregation of mandibular prognathism

    Directory of Open Access Journals (Sweden)

    April Lee

    2015-04-01

    Full Text Available Mandibular prognathism is a hereditary condition where there is an excess growth of the mandible in relation to the maxilla that can be associated with maxillary retrusion, mandibular protrusion, or both. Skeletal mandibular prognathism is most prevalent in Eastern Asian populations. This paper focuses on a Korean family with skeletal mandibular prognathism that was inherited through three generations. Apparently, neither mandible nor maxilla is retruded in the affected individuals, but there is a concave facial profile. The dentition has a class I occlusion with skeletal mandibular prognathism, and the only way to treat this case would be orthognathic surgery with the help of orthodontic appliances.

  1. Medial Femoral Condyle Degeneration Associated with a Mediopatellar Plica

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    Mehmet Balik

    2014-03-01

    Full Text Available Sixty-years-old female patient complaining from knee pain since 15 years. The patient could not localize the pain at first. Since 10 years, she experiences a temporary pain localized at the medial side of tibiofemoral joint during twisting her knee. Also, pain persists at the medial patellar region at semi-flexed position of her knee. The patient did not benefit from conversative treatment with the diagnosis of gonarthrosis. We performed knee artrhroplasty. During arthroplasty, we observed that the medial femoral condyle was damaged due to long term mediopatellar plica impingement.

  2. Difficulties encountered in preauricular approach over retromandibular approach in condylar fracture

    Science.gov (United States)

    Jayavelu, Perumal; Riaz, R.; Tariq Salam, A. R.; Saravanan, B.; Karthick, R.

    2016-01-01

    Fracture of mandible can be classified according to its anatomical location, in which condylar fracture is the most common one overall and is missed on clinical examination. Due to the unique geometry of the mandible and temporomandibular joint, without treatment the fractures can result in marked pain, dysfunction, and deformity. The condylar fracture may be further classified depending on the sides involved: unilateral/bilateral, depending on the height of fracture: intracapsular (within the head of condyle), extracapsular - head and neck (high condyle fracture), and subcondylar (low condyle fracture), and depending on displacement: nondisplaced, displaced (anteromedially, medially, and lateral), and dislocated. The clinical features include swelling and tenderness over the temporomandibular joint region, restricted mouth opening, and anterior open bite. A 34-year-old male patient reported to the Department of Oral and Maxillofacial Surgery at Madha Dental College and Hospital; suffered fall trauma resulting in bilateral condyle fracture, dentoalveolar fracture in mandible with restricted mouth opening, and anterior open bite. PMID:27829774

  3. Difficulties encountered in preauricular approach over retromandibular approach in condylar fracture

    Directory of Open Access Journals (Sweden)

    Perumal Jayavelu

    2016-01-01

    Full Text Available Fracture of mandible can be classified according to its anatomical location, in which condylar fracture is the most common one overall and is missed on clinical examination. Due to the unique geometry of the mandible and temporomandibular joint, without treatment the fractures can result in marked pain, dysfunction, and deformity. The condylar fracture may be further classified depending on the sides involved: unilateral/bilateral, depending on the height of fracture: intracapsular (within the head of condyle, extracapsular - head and neck (high condyle fracture, and subcondylar (low condyle fracture, and depending on displacement: nondisplaced, displaced (anteromedially, medially, and lateral, and dislocated. The clinical features include swelling and tenderness over the temporomandibular joint region, restricted mouth opening, and anterior open bite. A 34-year-old male patient reported to the Department of Oral and Maxillofacial Surgery at Madha Dental College and Hospital; suffered fall trauma resulting in bilateral condyle fracture, dentoalveolar fracture in mandible with restricted mouth opening, and anterior open bite.

  4. Avoiding occlusal derangement in facial fractures: An evidence based approach

    Directory of Open Access Journals (Sweden)

    Derick Mendonca

    2013-01-01

    Full Text Available Facial fractures with occlusal derangement describe any fracture which directly or indirectly affects the occlusal relationship. Such fractures include dento-alveolar fractures in the maxilla and mandible, midface fractures - Le fort I, II, III and mandible fractures of the symphysis, parasymphysis, body, angle, and condyle. In some of these fractures, the fracture line runs through the dento-alveolar component whereas in others the fracture line is remote from the occlusal plane nevertheless altering the occlusion. The complications that could ensue from the management of maxillofacial fractures are predominantly iatrogenic, and therefore can be avoided if adequate care is exercised by the operating surgeon. This paper does not emphasize on complications arising from any particular technique in the management of maxillofacial fractures but rather discusses complications in general, irrespective of the technique used.

  5. 下颌角骨折坚强内固定生物力学的三维有限元法分析%Biomechanical analysis of rigid internal fixation for mandibular angle fracture through three-dimensional finite element method

    Institute of Scientific and Technical Information of China (English)

    贾娟; 吴双江; 夏德林

    2016-01-01

    Objective To analyze the stability of two-miniplate internal fixation and tension band internal fixa-tion for mandibular angle fracture by three-dimensional finite element method (3D-FEM). Methods A healthy adult volunteer was chosen. The normal mandible model was established by 3D-FEM, with the fracture line and internal fixa-tion system established, and finally, a three-dimensional finite element model was established. The maximum stress and the relative displacement of fracture of the two internal fixation methods for anterior teeth occlusion, bilateral posterior teeth occlusion, left posterior teeth occlusion and right posterior teeth occlusion were analyzed. Results The maximum stress concentrated in the middle of the titanium plate for tension band internal fixation, and in the middle of the upper plate for two-miniplate internal fixation. The maximum stress of tension band internal fixation was lower than that of two-miniplate internal fixation for anterior teeth occlusion and contralateral posterior teeth occlusion, and the relative dis-placement of fracture of tension band internal fixation was larger for anterior teeth occlusion and contralateral posterior teeth occlusion (0.15 mm more than safe shift threshold). Conclusion Mandibular angle fracture model is established under the three dimensional finite element model with good credibility. The stability of two-miniplate internal fixation is higher than that of tension band internal fixation. Guidance for the adjustment of occlusal force should be performed to make the stability in safe range when treating mandibular angle fracture with tension band internal fixation.%目的 采用三维有限元法分析下颌角骨折张力带固定与双列小型板内固定的稳定性.方法 选取健康成年志愿者1例,通过三维有限元法建立正常下颌骨模型,建立骨折线,制作内固定系统,并最终建立三维有限元模型,分析前牙咬合、双侧后牙咬合、左侧后牙咬合和右

  6. Mandibular remodeling measured on cephalograms: 2. A comparison of information from implant and anatomic best-fit superimpositions.

    Science.gov (United States)

    Baumrind, S; Ben-Bassat, Y; Korn, E L; Bravo, L A; Curry, S

    1992-09-01

    This study quantifies the differences in the perceived pattern of mandibular remodeling when two different methods are used to superimpose roentgenographic images of the mandible. Lateral cephalograms for a group of subjects with metallic implants of the Björk type were superimposed twice; first on the metallic implants and then independently on mandibular anatomic structures according to a common "best fit" rule. In this article, we compare the between-superimposition differences in the perceived displacements of condyle, gonion, menton, pogonion, and Point B. Mean differences between the two superimpositional techniques were smaller than had been anticipated. For the 7-year time interval between 8.5 and 15.5 years, the largest mean differences between methods were 2.70 mm in the horizontal direction at condyle, 1.90 mm in the vertical direction at condyle, and 1.52 mm in the vertical direction at gonion. None of the other between-superimposition differences had a mean value in excess of 1 mm. The individual case variability between the two methods was, however, quite considerable, a finding that we believe has bearing on the confidence that can be placed in individual case analyses in clinical orthodontics. A preliminary attempt has been made to represent and discuss the magnitude of this problem.

  7. AngleⅡ类错患者髁突表面积与体积三维重建测量%Three-dimensional reconstruction study of condyle volume and surface area in Angle′s class II malocclusion patients

    Institute of Scientific and Technical Information of China (English)

    杨珊; 何科; 任嫒姝; 戴红卫

    2012-01-01

    目的 运用锥束CT(CBCT)测量AngleⅡ类错患者髁突的表面积和体积,探讨AngleⅡ类错患者髁突形态大小的特点.方法 选择该院正畸科就诊患者中年龄为20~28岁的AngleⅡ类错患者66例(男33例,女33例)进行CBCT检查,运用Mimics10.0软件对左、右两侧髁突进行三维重建,测量其表面积与体积,计算髁突形态指数.并与AngleⅠ类错患者髁突大小进行比较.结果 AngleⅡ类错患者男性的髁突体积与表面积均大于女性(P0.05).结论 AngleⅡ类错患者的髁突大小与性别和髁突位置有关.且AngleⅡ类错患者髁突小于AngleⅠ类错患者.%Objective To measure the condyle volume and surface area in the patients with Angle s class Ⅱ malocclusion by cone beam CT(CBCT) and to study the characteristics of mandibular condylar size. Methods 66 young patients with Angle's class Ⅱ malocclusion were chosen from our hospital(aged 20 - 28 years;33 males and 33 females). All patients received CBCT examina tion,the CT slice used the Mimics 10. 0 software for three dimensional reconstruction of the condyle to measure the condyle vol ume,surface area and shape index(ratio of volume and surface area). The comparison between class Ⅱ malocclusion patients and class Ⅰ malocclusion patients was performed. Results The condyle volume and surface area in male patients with class Ⅱ maloc elusion were significantly greater than those in female patients(P0. 05). Conclusion The condyle volume is related to the genders and condyle position. The size of man dibular condyle in class Ⅱ malocclusion patients is smaller than class Ⅰ malocclusion patients.

  8. Dose-dependent effects of genistein on bone nomeostasis in rats' mandibular subchondral bone

    Institute of Scientific and Technical Information of China (English)

    Yong-qi LI; Xiang-hui XING; Hui WANG; Xi-li WENG; Shi-bin YU; Guang-ying DONG

    2012-01-01

    To investigate the effect of genistein on bone homeostasis in mandibular subchondral bone of rats.Methods:Female SD rats were administered with genistein (10 and 50 mg/kg) or placebo by oral gavage for 6 weeks.Then the animals were sacrificed,and histomorphology and micro-structure of mandibular condyle were examined using HE staining and micro-CT analysis,respectively.The expression levels of alkaline phosphatase (ALP),osteocalcin (OC),osteoprotegerin (OPG),the receptor activator of nuclear factor KB ligand (RANKL) and estrogen receptors (Ers) in mandibular condyle were detected using real-time PCR.Cultured osteoblasts were prepared from rat mandibular condyle for in in vitro study.The cells were treated with genistein (10-7 or 10-4 mol/L) for 48 h.The expression of the bone homeostasis-associated factors and estrogen receptors (Ers) was detected using realtime PCR,and ER silencing was performed.Results:At both the low- and high-doses,genistein significantly increased the bone mineral density (BMD) and bone volume,and resulted in thicker subchondral trabecular bone in vivo.In both in vivo and in vitro study,the low-dose genistein significantly increased the expression of ALP,OC and OPG,but decreased the expression of RANKL and the RANKL/OPG ratio.The high-dose genistein decreased the expression of all these bone homeostasis-associated factors.Both the low and high doses of genistein significantly increased the expression of Erβ,while Erα expression was increased by the low dose genistein and decreased by the high dose genistein.Erβ silencing abrogated most of the effects of genistein treatment.Conclusion:In rat mandibular condylar subchondral bone,low-dose genistein increases bone formation and inhibit bone resorption,while excess genistein inhibits both bone formation and resorption.The effects of genistein were predominantly mediated through Erβ.

  9. Three-dimensional surgical changes of mandibular proximal segments affect outcome of jaw motion analysis.

    Science.gov (United States)

    Wen-Ching Ko, Ellen; Alazizi, Abdelmounem Issam; Lin, Cheng-Hui

    2015-05-01

    Displacement of the mandibular proximal segments is inevitable in surgical correction of the asymmetric mandible. The aim of the present study was to assess the outcomes of jaw motion analysis (JMA) in relation to the changes in the mandibular proximal segments after orthognathic surgery (OGS). The present retrospective cohort study investigated the surgical changes using the cone-beam computed tomography records and the mandibular function with JMA and a temporomandibular joint (TMJ) examination. The predictor variables were the 3-dimensional (3D) changes in the proximal segments on the deviated and nondeviated sides. The outcome variables were the JMA data obtained 6 months after OGS. The Pearson correlation test was performed to assess the relationship between the surgical changes and the outcome of JMA. Twenty-one adult patients with skeletal Class III malocclusion and mandibular deviation greater than 4 mm were included in the present study. The change of the ramus axis to the coronal plane on the deviated side correlated negatively with the laterotrusive movement of the mandible toward the deviated side (r = -0.452, P < .05). The changes in the distance from the condyles to the midsagittal plane and the angulation of the ramus axis to midsagittal plane on the nondeviated side correlated negatively with the condyle range of retrusion on both sides. However, the increase in the angulation of the ramus axis to the midsagittal plane on the nondeviated side correlated positively with the angle of the horizontal condylar movement in laterotrusion on the deviated side (r = 0.458, P < .05). 3D model visualization enabled us to clearly detect the changes in the proximal segments after OGS. A relationship between the condylar range of motion and skeletal changes in the proximal segments in patients with Class III malocclusion was observed, mainly on the deviated side of the mandible. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published

  10. Mandibular condylar hyperplasia: clinical, histopathological, and treatment considerations.

    Science.gov (United States)

    Angiero, Francesca; Farronato, Giampietro; Benedicenti, Stefano; Vinci, Raffaele; Farronato, Davide; Magistro, Sarah; Stefani, Michele

    2009-01-01

    Condylar hyperplasia is a rare disorder characterized by an increased volume of the condyle, ramus, and mandibular body leading to facial asymmetry. We present three cases of condylar hyperplasia: two women and one man, age range 27 to 34. Clinically, all three patients showed a deviation of the mandible to the opposite side and a protruded position of the chin, hypertrophy of the lower border of the mandible, combined with an elongation of the mandibular ramus, open-bite on the deformed side, and cross-bite on the opposite side. In all three cases, scintigraphy showed an increased uptake. Radiography and CT scanning confirmed the clinical diagnosis and patients were subjected to surgery, comprising high condylectomy on the affected side with access in the pre-tragus area. The surgical piece sent to the Institute of Pathological Anatomy for histological examination revealed a nonuniform picture, in terms of both the depth of cartilage islands and the thickness of the fibrous layer covering the joint surface. Common to all three cases, however, was the apparent evolution of fibrous tissue to cartilage, and of this to compact bone tissue. At two-four years, all cases have maintained a good occlusal response. The asymmetric deformity of the mandible resulting from the rare condition of hemimandibular hyperplasia is presented and the clinical, histopathological and therapeutic aspects discussed.

  11. Mechanical analysis on individualized finite element of temporal-mandibular joint under overlarge jaw opening status.

    Science.gov (United States)

    Sun, Mingxu; Yang, Jianjun; Zhou, Ruizhi; Li, Ningyi; Xia, Junnan; Gu, Fang

    2015-01-01

    Analyze the stress status of temporal-mandibular joint (TMJ) of a healthy volunteer under the overlarge jaw opening status through the finite element method, with the purpose of clarifying the loading features of each structure in the joint area, and achieving further understanding of the pathogenesis of the temporomandibular disorders (TMD). Collect the CBCT and MRI data of a volunteer respectively under the maximum jaw opening, establish the finite element model (FEM) of TMJ under the maximum jaw opening status through a series of software, image segmentation, rectification, meshing, material evaluation and other related processing, simulate the mechanical environment of this joint area under this status, and analyze the stress status of the articular disc, condyle cartilage, and condyle process. Based on CT and MRI image data, build 3D model and FEM of TMJ, fully simulate the mechanical environment under the large jaw opening status, and calculate the stress value of the articular disc, condyle process and condylar cartilage. This research result reminds us that the normal people's articular disc are easy to generate stress concentration under large jaw opening, but its stress is far less than the one under the tight biting status. Perhaps the TMJ symptom induced under the large jaw opening status is mainly caused by the displacement of the articular disc. Under the large jaw opening status, the condylar cartilage plays a vital role in dispersing the stress. This method can be applied for carrying out individualized mechanical analysis on the patients with TMD.

  12. Osteosynthesis of fractures of the femur with flexible metallic intramedullary nails.

    Science.gov (United States)

    Firica, A; Troianescu, O; Petre, M

    1978-04-01

    The authors discuss their use of Ender's method in the treatment of fractures of the femur. The diameter and length of the nails depends on the type of fracture. 1) Three nails of 4 mm diameter are introduced in parallel from the medial condyle in fractures of the femoral neck; 2) 5 mm nails are used, in similar fashion, for the fixation of intertrochanteric and subtrochanteric fractures; 3) 5 mm nails are used for diaphyseal, supracondylar and intercondylar fractures, introduced in crossed fashion ("Eiffel Tower" technique) from both medial and lateral condyles. This method of fixation has proved to be extremely stable. The operation itself is quick, with no blood loss or shock. The patient can resume partial weight bearing after a week in stabilised intertrochanteric and shaft fractures, after a month in less stable types, and after three to four months in fractures of the neck of the femur. This report is based on the first 250 cases treated by this method.

  13. Conseqüências no crescimento de maxila e mandíbula de defeito ósseo cirúrgico no ramo da mandíbula de ratos Consequences on the growth of maxilla and mandible of surgical bone defect on mandibular ramus of rats

    Directory of Open Access Journals (Sweden)

    Lucimar Rodrigues

    2004-10-01

    Full Text Available OBJETIVO: Analisar as conseqüências no crescimento de maxila e mandíbula de defeito ósseo cirúrgico simulando fratura no ramo da mandíbula. MÉTODOS: Foram utilizados 25 ratos Wistar com um mês de idade. Sob anestesia geral e por meio de incisão submandibular. Foi realizada osteotomia vertical no ramo da mandíbula do lado direito com emprego de motor cirúrgico. Após período de dois meses os animais foram sacrificados, os tecidos moles retirados e as hemimandíbulas desarticuladas. Foram realizadas incidências radiográficas axiais para o crânio e laterais para as hemimandíbulas. A seguir, por intermédio de um sistema de computador foram obtidas medidas lineares da maxila e das hemimandíbulas. Foi empregado o teste "t" de Student para verificação da significância da diferença entre os lados experimental e controle. RESULTADOS: A diferença foi significante para a altura do ramo (p=0,010 e comprimento da mandíbula referente ao côndilo (p=0,015 e ao ângulo (pPURPOSE: To analyse the consequences on the growth of maxilla and mandible of a surgical bone defect that simulates a mandibular ramus fracture. METHODS: A group of 25 one-month-old Wistar rats were used in this study. Under general anesthesia, and through a submandibular incision, a vertical osteotomy on the right side of the mandibular ramus was made using a surgical drill. The animals were sacrificed after two months, soft tissues removed, and the mandible disarticulated. The skull was submitted to axial radiograph and the hemimandibles to a lateral radiograph. With these, cephalometric mensurations were made through a computer system, and the obtained values submitted to Student's t-test. RESULTS: The height of the mandibular ramus presented significant difference (p=0,010 as well as the length of mandible, both to the condyle (P=0,015 and the angle (p=0,001. There was no significant difference to the mensurations of the maxilla. CONCLUSION: The consequences of the

  14. 两种颌后切口入路治疗下颌骨髁突骨折的比较研究%Two retromandibular approachs for condylar neck fracture reduction

    Institute of Scientific and Technical Information of China (English)

    辛江波; 袁渭; 兴辰; 李东振

    2015-01-01

    目的:探讨两种颌后入路治疗下颌骨髁突颈骨折的治疗效果。方法:68例成人下颌骨中低位髁突颈骨折患者,随机分为A、B两组,经颌后入路,分别采用腮腺前缘入路及腮腺后下极入路,解剖复位髁突骨折行坚强内固定术。结果:68例患者均取得良好解剖复位,咬合关系恢复良好,无关节强直出现。A组2例出现面神经麻痹。B组1例出现涎瘘,4例出现面神经麻痹症状。结论:颌后入路可有效治疗髁突骨折,且腮腺前缘入路较腮腺后下极入路减少了手术并发症的发生。%Objective To discuss the two beneficiaries of a novel retromandibular approach for mandibular condyle neck fracture reduction. Methods 68 patients were consisted in this study.34 patients were treated with Parotid gland after Approach,the other 34 patients were treatd with Parotid gland front Approach. Results All 68 cases achieved good anatomic reduction,occlusal relationship was in good recovery,and degree of mouth opening restored to preoperative level.A team had two patients facial nerve injury,B team had four parients facial nerve injury.and one patients Salivary fistula. Conclusion Retromandibular approach is convenient and effective in condyle neck fracture reduction. And Parotid gland front Approach reduce the surgical complications.

  15. A comparative study of the detectability of TMJ radiographic techniques for artificial mandibular condylar lesions

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Hee Jeong; Jung, Yeon Hwa; Cho, Bong Hae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Pusan(Korea, Republic of)

    1997-08-15

    The purpose of this study was to evaluate the detectability of various radiographic techniques for mandibular condylar lesions. Erosive lesion, osteophyte and flattening were formed on the artificial mandibular condyle, and panoramic, transcranial, transorbital radiography, lateral and frontal tomography were taken. The results were as follows; 1. The detectability for erosive lesions was superior in the order of frontal tomography (96%), lateral tomography (78%), transorbital (59%), transcranial (56%) and panoramic (48%) radiography. 2. The location of erosive lesion that showed the highest detectability was the medial third in panoramic, the lateral third in transcranial, the central portion of anteroposterior direction in transorbital, the central portion of mediolateral direction and the posterior third in lateral tomography. Frontal tomography disclosed all erosive lesions except one anterolateral lesion. 3. The detectability of osteophyte was 100% in lateral tomography, 78% in transcranial and 56% in panoramic radiography. 4. For flattening, lateral tomography showed the flattened condyle, but both panoramic and transcranial views showed only decreased bone density without the change of condylar shape.

  16. Use of {sup 99m}Tc-MDP SPECT for assessment of mandibular growth: development of normal values

    Energy Technology Data Exchange (ETDEWEB)

    Fahey, Frederic H.; Treves, S. Ted [Children' s Hospital Boston, Division of Nuclear Medicine, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Abramson, Zachary R.; Nissenbaum, Mark [Harvard School of Dental Medicine, Boston, MA (United States); Massachusetts General Hospital, Department of Oral and Maxillofacial Surgery, Boston, MA (United States); Padwa, Bonnie L. [Harvard Medical School, Boston, MA (United States); Harvard School of Dental Medicine, Boston, MA (United States); Children' s Hospital Boston, Department of Plastic and Oral Surgery, Boston, MA (United States); Zimmerman, Robert E. [Brigham and Women' s Hospital, Division of Nuclear Medicine, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Zurakowski, David [Children' s Hospital Boston, Department of Orthopaedics, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Kaban, Leonard B. [Harvard Medical School, Boston, MA (United States); Harvard School of Dental Medicine, Boston, MA (United States); Massachusetts General Hospital, Department of Oral and Maxillofacial Surgery, Boston, MA (United States)

    2010-05-15

    Planar scintigraphy using {sup 99m}Tc-labeled methylene diphosphonate ({sup 99m}Tc-MDP) has been established as a method for evaluating mandibular growth and asymmetry. However, {sup 99m}Tc-MDP single photon emission computed tomography (SPECT) provides improved image contrast and quantitative capability potentially allowing the clinician to make a more accurate assessment of the stage of activity of normal and asymmetric mandibular growth. The purpose of this study was to utilize {sup 99m}Tc-MDP SPECT in normal subjects to develop a standardized approach to imaging the mandible that could subsequently be used to evaluate patients with potential for mandibular growth abnormalities. Thirty-two patients (22 females, 10 males, 8-25 years of age, mean of 14 years) having {sup 99m}Tc-MDP bone scans (7.4 MBq/kg, maximum of 518 MBq) for indications not involving the head were asked to have an additional SPECT that included the mandibular condyles. Internal (clivus) and external (source of known activity included within the field of view) standards were both investigated. Two- and three-dimensional (2-D and 3-D) regions of interest (ROI) were drawn over each condyle and the clivus in a single slice containing the maximum pixel value within the structure. A 3-D ROI was also drawn about the external standard. Maximum and average pixel values within the 2-D and 3-D ROIs were recorded. Correlation analysis indicated that essentially the same information was obtained whether the maximum or average pixel value within a 2-D or 3-D ROI was used. The right to left ratio provided a parameter that can be used to assess the magnitude of mandibular metabolic asymmetry. Use of an external standard provides the potential for quantifying condylar uptake for assessment of the activity of mandibular growth. Normal ranges for different age groups were determined for condylar uptake using both internal and external standards. {sup 99m}Tc-MDP SPECT provides a quantitative method for assessing

  17. Analysis of sagittal condyl inclination in subjects with temporomandibular disorders

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    Dodić Slobodan

    2010-01-01

    Full Text Available Bacground/Aim. Disturbances of mandibular border movements is considered to be one of the major signs of temporomandibular disorders (TMD. The purpose of this study was to evaluate the possible association between disturbances of mandibular border movements and the presence of symptoms of TMD in the young. Methods. This study included two groups of volunteers between 18 and 26 years of age. The study group included 30 examineers with signs (symptoms of TMD, and the control group also included 30 persons without any signs (symptoms of TMD. The presence of TMD was confirmed according to the craniomandibular index (Helkimo. The functional analysis of mandibular movements was performed in each subject using the computer pantograph. Results. The results of this study did not confirm any significant differences between the values of the condylar variables/sagittal condylar inclination, length of the sagital condylar guidance, in the control and in the study group. Conclusion. The study did not confirm significant differences in the length and inclination of the protrusive condylar guidance, as well as in the values of the sagittal condylar inclination between the subjects with the signs and symptoms of TMD and the normal asymptomatic subjects.

  18. Posterior bicondylar tibial plateau fractures.

    Science.gov (United States)

    Carlson, DuWayne A

    2005-02-01

    To present a case series of patients with posterior bicondylar tibial plateau fractures treated by direct fracture exposure and fixation through dual incisions. Retrospective clinical study. Level 1 trauma centers. Eight patients were identified that had posterior bicondylar tibial plateau fractures. Two patients had depressed posterolateral tibial plateau fractures with contained defects and did not have direct fracture exposure. One patient died of medical problems leaving 5 patients who underwent direct fracture exposure, reduction, and fixation. Posteromedial followed by posterolateral open reduction and internal fixation of posterior bicondylar tibial plateau fractures. At 6 to 24 months follow-up (mean 13 months), all patients returned to near full activities, each with aching after prolonged standing (8-hour shift). Range of motion averaged 2 degrees to 121 degrees of flexion. Three of 5 returned to manual labor jobs; the others were not employed at the time of injury. Posterior bicondylar tibial plateau fractures have a high association with lateral meniscal pathology and can be associated with anterior cruciate ligament injury. Reduction of the posterior plateau condyles is easiest with the knee in full extension. Flexion contractures can be a problem, and patients should be encouraged to regain/maintain knee extension. The dual-incision approach to these challenging fractures can result in good to excellent knee function for these patients.

  19. Evaluation of relationship of hand wrist radiograph, cervical vertebral maturation with mandibular growth as skeletal maturity indicators in children

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    Ziauddin Mohammad

    2016-01-01

    Full Text Available Objective: To study the correlation between mandibular growth variables using linear measurements of ramus, body of the mandible and total mandibular length with skeletal maturity indicators such as hand wrist radiographs and cervical vertebral maturation. Materials and Methods: A total of 315 patient-records (lateral cephalograms and hand-wrist radiographs in the age group of 10–13 years were involved. The cephalometric measurements, representative of the mandibular growth, Condylion-Gonion (Co-Go, Condylion-Gnathion (Co-Gn, Gonion-Gnathion (Go-Gn, and posterior-most point of the mandibular condyle-pogonion (Fg-Pg were traced (McNamara method. The correlation of mandibular growth variables with hand wrist parameters and cervical vertebrae maturation were assessed separately in male and female. Pearson's correlation was used for analysis (Statistical Package for Social Sciences version 17. Results: Only 80 subjects were included in final analysis. A highly significant correlation was found among hand wrist parameters, and mandibular growth variables (P < 0.001 in both genders. Among males, there was a highly significant correlation between cervical vertebral maturation and mandibular growth variables (P < 0.001, whereas Co-Go has a significant correlation with C2Conc, C3Conc, and C4Conc (P < 0.05. In females, Co-Gn, Co-Go, Go-Gn, and Fg-Pg were significantly correlated with C3Conc and C4Conc (P < 0.001. Conclusion: Both the cervical vertebral maturation and mandibular growth variables can be accessed on the lateral ephalogram itself for the evaluation of the skeletal maturity, as effective as a hand wrist radiograph in males and females.

  20. Mandibular repositioning modulates IGFBP-3, -4, -5 and -6 expression in the mandibular condylar cartilage of young rats.

    Science.gov (United States)

    Hajjar, Denise; Santos, Marinilce F; Kimura, Edna Teruko

    2006-01-01

    Functional orthopedic appliances correct dental malocclusion partially by exerting indirect mechanical stimulus on the condylar cartilage, modulating growth and the adaptation of orofacial structures. However, the exact nature of the biological responses to this therapy is not well understood. Insulin-like growth factors I and II (IGF-I and II) are important local factors during growth and differentiation in the condylar cartilage [D. Hajjar, M.F. Santos and E.T. Kimura, Propulsive appliance stimulates the synthesis of insulin-like growth factors I and II in the mandibular condylar cartilage of young rats, Arch. Oral Biol. 48 (2003), 635-642]. The bioefficacy of IGFs at the cellular level is modulated by IGF binding proteins (IGFBP). The aim of this study was to verify the mRNA and protein expression of IGFBP-3, IGFBP-4, IGFBP-5 and IGFBP-6 in the condylar cartilage of young male Wistar rats that used a mandibular propulsive appliance for 3, 9, 15, 20, 30 or 35 days. For this purpose, sagittal sections of decalcified and paraffin-embedded condyles were submitted to immunohistochemistry and the condylar cartilage to RT-PCR. The control group showed a gradual increase in the protein expression of all IGFBPs, except IGFBP-4. Following use of the appliance, IGFBP-3 and IGFBP-6 expression decreased in the early stage of the treatment. At 20 days of treatment there was a decline in the IGFs and IGFBP-3, IGFBP-4 and IGFBP-5 expression and at 30 days there was a peak in the IGFs and all IGFBPs expression except for IGFBP-3 where the peak was observed in the control animals. The expression patterns of all IGFBPs in the condylar cartilage were similar. The modulation of IGFBP-3, -4, -5 and -6 expression in the condylar cartilage in response to the propulsive appliance suggests that those peptides are involved in the mandibular adaptation during this therapy.

  1. [Mandibular manipulation technique followed by exercise therapy and occlusal splint for treatment of acute anterior TMJ disk displacement without reduction].

    Science.gov (United States)

    Jiang, Xin; Fan, Shuai; Cai, Bin; Fang, Zhong-Yi; Xu, Li-Li; Liu, Li-Kun

    2016-10-01

    This study aimed to evaluate the short-term efficiency of mandibular manipulation technique combined with exercise therapy and splint treatment of acute anterior TMJ disc displacement without reduction (ADDW), and TMJ disc-condyle relationship by magnetic resonance imaging (MRI). Forty-four patients (37 females, 7 males) were diagnosed as acute ADDW and confirmed by MRI. All patients underwent mandibular manipulation, combined with exercise therapy, including jaw movement exercise, stabilization exercise, disc reposition exercise, and splint treatment. Anterior repositioning splint was wore only at night during sleep, while the mandible was kept in rest position during the day. The treatment was continued for 2 weeks. The baseline and endpoint outcome assessment measures were maximum active mouth opening, visual analogue scale (VAS) score of TMJ pain. Consecutive MRI was performed 1~3 months after treatment. SPSS 17.0 software package was used for statistical analysis. Two weeks after treatment, the patients' maximum active mouth opening increased from(22.6±6.1) mm to (43.9±3.3) mm, VAS score of pain decreased from 3.6±1.5 to 0.7±0.25. After treatment of 4.6±4.7 weeks on average, 20 patients (46%) displayed normal dis-condyle relationship, 16 patients(36%) had displacement with reduction, and 8 patients(18%) had displacement without reduction on MRI. Mandibular manipulation technique combined with exercise therapy and splint treatment seems to be useful in the treatment of anterior TMJ disc displacement with reduction, which can help to maintain the complete anatomic disc-condyle relationship.

  2. Three-dimensional assessment of mandibular advancement 1 year after surgery

    Science.gov (United States)

    de Assis Ribeiro Carvalho, Felipe; Cevidanes, Lucia Helena Soares; Motta, Alexandre Trindade Simões da; de Oliveira Almeida, Marco Antonio; Phillips, Ceib

    2010-01-01

    Introduction This prospective observational study evaluated changes in the 3-dimensional position and remodeling of the mandibular rami, condyles, and chin at splint removal and 1 year after mandibular advancement surgery. Methods Presurgery, splint removal (4–6 weeks postsurgery), and 1-year postsurgery cone-beam computed tomography scans of 27 subjects were used. Superimposition on the cranial base was used to assess positional or remodeling changes in the anatomic regions of interest. Surface distance displacements were visually displayed and quantified by 3-dimensional color maps. A 1-sample t test was used to assess the average postsurgical changes of each region of interest. The level of significance was set at 0.05. Results After antero-inferior chin displacement with surgery (mean, 6.81 ± 3.2 mm at splint removal), the average 1-year post-surgery displacement was not statistically significant (P = 0.44). Postsurgical adaptations greater than 2 mm were observed in 48% of the patients: 16% with an additional anterior-inferior displacement of the chin of 2 to 4 mm, and 4% with ≥4 mm; 20% had postero-superior movement of 2 to 4 mm, and 8% had postero-superior movement of ≥4 mm. The condyles tended to move, on average, ≤2 mm supero-posteriorly with surgery, and this small positional displacement was maintained 1 year postsurgery (right condyle, P = 0.58; left, P = 0.88). The rami exhibited outward (lateral) movements with surgery, with greater displacement of the inferior part of the rami (≥2 mm in 65% of the subjects). This torque of the ramus with surgery was stable 1 year postsurgery. Conclusions Three-dimensional assessment of skeletal changes with mandibular advancement surgery shows that nearly half of the patients have >2 mm change in chin position from splint removal to the 1-year follow-up, with approximately equal chances of anterior and posterior movement. Torque of the rami usually occurs with mandibular advancement surgery. PMID:20381760

  3. Osteomyelitis variolosa with fracture: A unique case report

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    Pradeep K Singh

    2012-01-01

    Full Text Available Smallpox has been eradicated completely but its unique pathology and sequlae are still found in routine clinical practice. We present a report of a patient having osteomyelitis variolosa in both elbow joints and wrist with fracture of humerus. The condyles were typically elongated as central portion of distal humerus absorbed. The fracture united uneventfully following stabilization with dynamic compression plate and bone grafting. Patient had satisfactory elbow function at the end of the last follow-up.

  4. Greenstick fracture of the mandible: A case report

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    Kalia V

    2008-03-01

    Full Text Available This case report is an insight in to pediatric traumatology whereby bilateral greenstick fracture of condyle is used as a means to discuss the incidence and anatomic considerations for the management of the same, highlighting the fact that dental surgeons require a unique understanding of the anatomy, growth considerations, healing pattern and operative management involving minimal manipulation while managing pediatric facial fractures.

  5. 切开复位内固定术治疗髁突骨折38例临床分析%The Clinical Effect Analysis of Open Reduction on Mandibular Condylar Fractures

    Institute of Scientific and Technical Information of China (English)

    王怀元; 朱坤鹍; 刘刚; 张朝奎; 郭维志

    2011-01-01

    Objective: Clinical study on the use of open reduction and fixation of condylar fractures. Methods:All 38 cases were treated with open reduction and internal fixation of condylar fractures, including 3 cases of old fractures, 35 patients with recent fractures, 12 cases are open fractures, 26 cases of a closed fracture, and 32 cases are unilateral condylar fracture, 6 cases are bilateral condylar fractures, joint head of condylar fractures in 4 patients, condylar neck fractures, 31 cases of condylar fracture of the base in 9 cases. In the opening degree based on observation after surgery, open type, occlusion, chewing ability and fracture healing, we conduct a comprehensive assessment of clinical efficacy. Results: 6 months after surgery, through the mouth opening, open type, occlusion of the assessment, obtained excellent surgery was 89. 5% ( 34/38 ). Conclusions: The use of open reduction and plate fixation for micro - condylar fractures can be determined, a reasonable choice of surgical indications, and standard surgical operation is to avoid surgical complications.%目的:探讨切开复位内固定手术治疗髁突骨折的临床疗效.方法:采用切开复位内固定术治疗髁突骨折38例,其中陈旧性骨折3例、新鲜骨折35例,开放性骨折12例、闭合性骨折26例,单侧髁突骨折32例、双侧髁突骨折6例,髁突头部骨折4侧、髁突颈部骨折31侧、髁突基部骨折9侧.术后观察开口度、开口型、咬牙合关系、咀嚼力及骨折愈合情况,对临床疗效进行综合评估.结果:术后6个月,开口度、开口型、咬牙合关系评估,优良率为89.5%(34/38).术后咀嚼力优34例,良3例,较差1例.术后影像学检查显示,34例髁突无移位,骨折无错位,髁突表面无明显吸收现象;3例上、下颌骨联合骨折因复位固定位置多骨折线未能达到解剖复位;1例术后因感染螺钉、钛板松动,髁突有再移位(角度<10°).结论:切开复位微型钛板内固定治疗

  6. Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle

    Energy Technology Data Exchange (ETDEWEB)

    Melloni, Pietro [Servei de Diagnostic per Imatge, Unitat de Diagnostic d' Alta Tecnologia (UDIAT), Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain); UDIAT, c/ Parc Tauli, s/n, 08208 Sabadell (Barcelona) (Spain); Valls, Rafael [Servei de Diagnostic per Imatge, Unitat de Diagnostic d' Alta Tecnologia (UDIAT), Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain); Yuguero, Mariano [Servei de Traumatologia i Ortopedia, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain); Saez, Amparo [Servei de Anatomia Patologica, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)

    2004-06-01

    We report a case of a mucoid degeneration of the anterior cruciate ligament (ACL) that produced osseous erosion of the medial aspect of the lateral femoral condyle. The MRI findings and differential diagnosis are discussed. (orig.)

  7. Radiologic assessment of maxillofacial, mandibular, and skull base trauma

    Energy Technology Data Exchange (ETDEWEB)

    Schuknecht, Bernhard [University Hospital of Zurich, Institute of Neuroradiology, Zurich (Switzerland); MRI-Medizinisch Radiodiagnostisches Institut, Zurich (Switzerland); Graetz, Klaus [University Hospital of Zurich, Department of Maxillofacial Surgery, Zurich (Switzerland)

    2005-03-01

    Cranio-maxillofacial injuries affect a significant proportion of trauma patients either in isolation or concurring with other serious injuries. Contrary to maxillofacial injuries that result from a direct impact, central skull base and lateral skull base (petrous bone) fractures usually are caused by a lateral or sagittal directed force to the skull and therefore are indirect fractures. The traditional strong role of conventional images in patients with isolated trauma to the viscerocranium is decreasing. Spiral multislice CT is progressively replacing the panoramic radiograph, Waters view, and axial films for maxillofacial trauma, and is increasingly being performed in addition to conventional films to detail and classify trauma to the mandible as well. Imaging thus contributes to accurately categorizing mandibular fractures based on location, into alveolar, mandibular proper, and condylar fractures - the last are subdivided into intracapsular and extracapsular fractures. In the midface, CT facilitates attribution of trauma to the categories central, lateral, or combined centrolateral fractures. The last frequently encompass orbital trauma as well. CT is the imaging technique of choice to display the multiplicity of fragments, the degree of dislocation and rotation, or skull base involvement. Transsphenoid skull base fractures are classified into transverse and oblique types; lateral base (temporal bone) trauma is subdivided into longitudinal and transverse fractures. Supplementary MR examinations are required when a cranial nerve palsy occurs in order to recognize neural compression. Early and late complications of trauma related to the orbit, anterior cranial fossa, or lateral skull base due to infection, brain concussion, or herniation require CT to visualize the osseous prerequisites of complications, and MR to define the adjacent brain and soft tissue involvement. (orig.)

  8. Fractures of the cervical spine

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    Raphael Martus Marcon

    2013-11-01

    Full Text Available OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2 and the lower cervical spine (C3-C7, according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification, which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.

  9. Fractures of the cervical spine

    Science.gov (United States)

    Marcon, Raphael Martus; Cristante, Alexandre Fogaça; Teixeira, William Jacobsen; Narasaki, Douglas Kenji; Oliveira, Reginaldo Perilo; de Barros Filho, Tarcísio Eloy Pessoa

    2013-01-01

    OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative. PMID:24270959

  10. Catastrophic complication following injection and extracorporeal shock wave therapy of a medial femoral condyle subchondral cystic lesion in a 14 year old Arabian mare

    Directory of Open Access Journals (Sweden)

    Darla K. Moser

    2017-05-01

    Full Text Available This report describes fibrous cyst lining injection and extracorporeal shock wave therapy (ESWT of a medial femoral condyle (MFC subchondral cystic lesion (SCL resulting in catastrophic MFC fracture in an Arabian mare. The mare was presented for evaluation of a severe hind limb lameness of approximately 4 months duration. On presentation, a non-weight bearing lameness of the left hind limb with severe effusion and soft tissue swelling of the stifle region was noted. Radiographic evaluation of the stifle revealed a large SCL of the MFC with associated osteoarthritis. Arthroscopic guided intra-lesional injection of the SCL with corticosteroids and autologous bone marrow concentrate was performed followed by ESWT of the MFC. The mare was discharged walking comfortably 48-hours post-operatively. An acute increase in lameness was noted 14 days post-operatively. Imaging revealed catastrophic fracture of the left MFC. Possible mechanisms leading to failure of the MFC secondary to the described treatment are discussed.

  11. Bone tissue stiffness in the mandibular condyle is dependent on the direction and density of the cancellous structure.

    NARCIS (Netherlands)

    Eijden, T.M. van; Ruijven, L.J. van; Giesen, E.B.W.

    2004-01-01

    Variation in the apparent stiffness of cancellous bone is generally ascribed to variation in cancellous structure and density, while the bone tissue stiffness is assumed to be constant. The purpose of the present study was to examine whether the bone tissue stiffness is dependent on the direction an

  12. TNF Accelerates Death of Mandibular Condyle Chondrocytes in Rats with Biomechanical Stimulation-Induced Temporomandibular Joint Disease.

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    Hongxu Yang

    Full Text Available To determine if temporomandibular joint chondrocyte apoptosis is induced in rats with dental biomechanical stimulation and what a role TNF takes.Thirty-two rats were divided into 4 groups (n = 8/group and exposed to incisor mal-occlusion induced by unilateral anterior crossbite biomechanical stimulation. Two groups were sampled at 2 or 4 weeks. The other two groups were treated with local injections of a TNF inhibitor or PBS into the temporomandibular joints area at 2 weeks and then sampled at 4 weeks. Twenty-four rats either served as unilateral anterior crossbite mock operation controls (n = 8/group with sampling at 2 or 4 weeks or received a local injection of the TNF inhibitor at 2 weeks with sampling at 4 weeks. Chondrocytes were isolated from the temporomandibular joints of 6 additional rats and treated with TNF in vitro. Joint samples were assessed using Hematoxylin&eosin, Safranin O, TUNEL and immunohistochemistry staining, real-time PCR, fluorogenic activity assays and Western blot analyses. The isolated chondrocytes were also analyzed by flow cytometry.Unilateral anterior crossbite stimulation led to temporomandibular joint cartilage degradation, associated with an increase in TUNEL-positive chondrocytes number, caspase-9 expression levels, and the release of cytochrome c from mitochondria at 2 weeks without changes in TNF and caspase-8 levels until after 4 weeks. TNF stimulated apoptosis of the isolated chondrocytes and up-regulated caspase-8 expression, but did not change caspase-9 expression levels. Local injection of TNF inhibitor down-regulated caspase-8 expression and reduced TUNEL-positive cell number, but did not reverse cartilage thickness reduction, caspase-9 up-regulation or cytochrome c release.Unilateral anterior crossbite stimulation induces mitochondrion-mediated apoptosis of articular chondrocytes. TNF accelerated the unilateral anterior crossbite induced chondrocytes apoptosis via death-receptor pathway. However, anti-TNF therapy does not prevent cartilage loss in this model of temporomandibular joint.

  13. Comparison of micro-CT and cone beam CT on the feasibility of assessing trabecular structures in mandibular condyle.

    Science.gov (United States)

    Liang, Xin; Zhang, Zuyan; Gu, Jianping; Wang, Zhihui; Vandenberghe, Bart; Jacobs, Reinhilde; Yang, Jie; Ma, Guowu; Ling, Haibin; Ma, Xuchen

    2017-07-01

    To evaluate the accuracy of CBCT in assessing trabecular structures. Two human mandibles were scanned by micro-CT (Skyscan 1173 high-energy spiral scan micro-CT; Skyscan NV, Kontich, Belgium) and CBCT (3D Accuitomo 170; Morita, Japan). The CBCT images were reconstructed with 0.5 and 1 mm thicknesses. The condylar images were selected for registration. A parallel algorithm for histogram computation was introduced to perform the registration. A mutual information (MI) value was used to evaluate the match between the images obtained from micro-CT and CBCT. In comparison with the micro-CT image for the two samples, the CBCT image with 0.5 mm thickness has a MI value of 0.873 and 0.903 while that with 1.0 mm thickness has a MI value of 0.741 and 0.752. The CBCT images with 0.5 mm thickness were better matched with micro-CT images. CBCT shows comparable accuracy with high-resolution micro-CT in assessing trabecular structures. CBCT can be a feasible tool to evaluate osseous changes of jaw bones.

  14. TNF Accelerates Death of Mandibular Condyle Chondrocytes in Rats with Biomechanical Stimulation-Induced Temporomandibular Joint Disease.

    Science.gov (United States)

    Yang, Hongxu; Zhang, Mian; Wang, Xin; Zhang, Hongyun; Zhang, Jing; Jing, Lei; Liao, Lifan; Wang, Meiqing

    2015-01-01

    To determine if temporomandibular joint chondrocyte apoptosis is induced in rats with dental biomechanical stimulation and what a role TNF takes. Thirty-two rats were divided into 4 groups (n = 8/group) and exposed to incisor mal-occlusion induced by unilateral anterior crossbite biomechanical stimulation. Two groups were sampled at 2 or 4 weeks. The other two groups were treated with local injections of a TNF inhibitor or PBS into the temporomandibular joints area at 2 weeks and then sampled at 4 weeks. Twenty-four rats either served as unilateral anterior crossbite mock operation controls (n = 8/group) with sampling at 2 or 4 weeks or received a local injection of the TNF inhibitor at 2 weeks with sampling at 4 weeks. Chondrocytes were isolated from the temporomandibular joints of 6 additional rats and treated with TNF in vitro. Joint samples were assessed using Hematoxylin&eosin, Safranin O, TUNEL and immunohistochemistry staining, real-time PCR, fluorogenic activity assays and Western blot analyses. The isolated chondrocytes were also analyzed by flow cytometry. Unilateral anterior crossbite stimulation led to temporomandibular joint cartilage degradation, associated with an increase in TUNEL-positive chondrocytes number, caspase-9 expression levels, and the release of cytochrome c from mitochondria at 2 weeks without changes in TNF and caspase-8 levels until after 4 weeks. TNF stimulated apoptosis of the isolated chondrocytes and up-regulated caspase-8 expression, but did not change caspase-9 expression levels. Local injection of TNF inhibitor down-regulated caspase-8 expression and reduced TUNEL-positive cell number, but did not reverse cartilage thickness reduction, caspase-9 up-regulation or cytochrome c release. Unilateral anterior crossbite stimulation induces mitochondrion-mediated apoptosis of articular chondrocytes. TNF accelerated the unilateral anterior crossbite induced chondrocytes apoptosis via death-receptor pathway. However, anti-TNF therapy does not prevent cartilage loss in this model of temporomandibular joint.

  15. Radiographic structural findings in mandibular condyle of orthodontically treated young patients, a possibility of an iatrogenic temporomandibular joint involvement

    Directory of Open Access Journals (Sweden)

    Arati Panchbhai

    2016-01-01

    Full Text Available Aim: Temporomandibular disorders joint disorders (TMD are commonly seen in population. There can be varied etiology to this. The purpose of the study was to study the possible association between orthodontic treatment and TMD. Materials and Methods: For the present study, the 720 subjects were assessed in 2 groups as orthodontically treated group (370 and control group without malocclusion (350. The structural findings were assessed as per the criteria. The data were subjected to statistical analysis using Chi-square test and Pearson's correlation. Results: For all the intergroup and intragroup, the findings were insignificant. Though insignificantly, marginal erosion was common finding followed by flattening and rarefaction. Conclusion: Overall, the study could not confirm the association that orthodontic treatment may lead to TMD. The next extensive study needs to be conducted considering clinical signs and symptoms and the long-term follow-ups.

  16. TNF Accelerates Death of Mandibular Condyle Chondrocytes in Rats with Biomechanical Stimulation-Induced Temporomandibular Joint Disease

    Science.gov (United States)

    Zhang, Hongyun; Zhang, Jing; Jing, Lei; Liao, Lifan; Wang, Meiqing

    2015-01-01

    Objective To determine if temporomandibular joint chondrocyte apoptosis is induced in rats with dental biomechanical stimulation and what a role TNF takes. Methods Thirty-two rats were divided into 4 groups (n = 8/group) and exposed to incisor mal-occlusion induced by unilateral anterior crossbite biomechanical stimulation. Two groups were sampled at 2 or 4 weeks. The other two groups were treated with local injections of a TNF inhibitor or PBS into the temporomandibular joints area at 2 weeks and then sampled at 4 weeks. Twenty-four rats either served as unilateral anterior crossbite mock operation controls (n = 8/group) with sampling at 2 or 4 weeks or received a local injection of the TNF inhibitor at 2 weeks with sampling at 4 weeks. Chondrocytes were isolated from the temporomandibular joints of 6 additional rats and treated with TNF in vitro. Joint samples were assessed using Hematoxylin&eosin, Safranin O, TUNEL and immunohistochemistry staining, real-time PCR, fluorogenic activity assays and Western blot analyses. The isolated chondrocytes were also analyzed by flow cytometry. Results Unilateral anterior crossbite stimulation led to temporomandibular joint cartilage degradation, associated with an increase in TUNEL-positive chondrocytes number, caspase-9 expression levels, and the release of cytochrome c from mitochondria at 2 weeks without changes in TNF and caspase-8 levels until after 4 weeks. TNF stimulated apoptosis of the isolated chondrocytes and up-regulated caspase-8 expression, but did not change caspase-9 expression levels. Local injection of TNF inhibitor down-regulated caspase-8 expression and reduced TUNEL-positive cell number, but did not reverse cartilage thickness reduction, caspase-9 up-regulation or cytochrome c release. Conclusions Unilateral anterior crossbite stimulation induces mitochondrion-mediated apoptosis of articular chondrocytes. TNF accelerated the unilateral anterior crossbite induced chondrocytes apoptosis via death-receptor pathway. However, anti-TNF therapy does not prevent cartilage loss in this model of temporomandibular joint. PMID:26529096

  17. Determination of the relationship between collagen cross-links and the bone-tissue stiffness in the porcine mandibular condyle

    NARCIS (Netherlands)

    Willems, N.M.B.K.; Mulder, L.; Bank, R.A.; Grünheid, T.; Toonder, J.M.J. den; Zentner, A.; Langenbach, G.E.J.

    2011-01-01

    Although bone-tissue stiffness is closely related to the degree to which bone has been mineralized, other determinants are yet to be identified. We, therefore, examined the extent to which the mineralization degree, collagen, and its cross-links are related to bone-tissue stiffness. A total of 50 ca

  18. Age-related changes in collagen properties and mineralization in cancellous and cortical bone in the porcine mandibular condyle

    NARCIS (Netherlands)

    Willems, N.M.B.K.; Langenbach, G.E.J.; Everts, V.; Mulder, L.; Grünheid, T.; Bank, R.A.; Zentner, A.; Eijden, T.M.G.J. van

    2010-01-01

    Collagen is an important constituent of bone, and it has been suggested that changes in collagen and mineral properties of bone are interrelated during growth. The aim of this study was to quantify age-related changes in collagen properties and the degree of mineralization of bone (DMB). The DMB in

  19. Composite mandibular allografts in canines

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To evaluate the feasibility of transplanting composite mandibular allografts to repair large mandibular defects. Methods: Three composite mandibular transplantation models were established. The first model consisted of hemimandible with the attached teeth, muscle and skin, and oral mucosa. The second model was transplanted in the same way with the first one excluding oral mucosa and some teeth, and third one excluding the oral mucosa and all dental crowns. Fourteen transplanting operations were performed in canines. Cyclosporine A and methylprednisone were given for immunosuppression. Results: The composite mandibular organs had an effective and closed return circuit. Transplantation of vascularized allograft of mandibular compound organs was feasible. Two longest time survivors of 67 d and 76 d were in the third model group. Cyclosporine A was successful in suppressing rejection of transplanted composite allograft and prolonging survival time of transplantation models. Conclusions: The composite mandibular allografts were available with large block of living composite tissue,and helpful in restoration of appearance and function for severe mandibular defects.

  20. CLINICAL APPLICATION OF WEAR BUCCAL APPARATUS COMBINED WITH INTRAORAL INCISION MINIMALLY INVASIVE TREATMENT ON MANDIBULAR ANGLE AND RAMI FRACTURES%穿颊器联合口内切口微创治疗下颌骨角部及升支骨折的临床应用

    Institute of Scientific and Technical Information of China (English)

    林旭征; 魏福海; 罗衍靖; 朱敏姬; 潘慧琦

    2015-01-01

    目的:探究分析利用穿颊器联合口内切口微创治疗下颌骨角部、升支骨折的临床应用及治疗效果。方法选取我院自2012年10月1日~2015年3月31日期间收治的下颌骨角部、升支骨折患者62例,作为临床研究对象。将所有患者进行随机分为对照组和观察组,每组各31例,对照组采用常规下颌下入路行骨折固定,观察组采用穿颊器联合口内切口入路微创治疗行骨折固定。对患者术后进行随访,记录并比较两组患者术后半年面颈部瘢痕、张口受限、腮腺涎漏、面神经损伤等并发症发生率及其临床疗效。结果观察组术后半年上下颌颌关系恢复情况明显优于对照组,其半年面颈部瘢痕、张口受限、腮腺涎漏、面神经损伤等并发症发生率(3.23%、0.00%、3.23%、6.45%)均明显小于对照组(29.03%、25.81%、32.26%、35.48%),且其手术显效率及总有效率(58.06%、90.32%)也均明显高于对照组(22.58%、29.03%),( p<0.05),差异具有统计学意义。结论利用穿颊器联合口内切口微创治疗下颌骨角部、升支骨折优势明显,手术创伤小,术后并发症少,患者颌关系恢复情况良好,有一定的临床优势,值得推广使用。%Objective To explore the clinical application and effect of wearing buccal apparatus combined with intraoral incision minimally invasive treatment of mandibular angle and rami fractures .Methods 62 patients of Mandibular angle and ramus fractures during the march month 31 from October 1, 2012 to 2015 in our hospital were selected as a clinical research object .All the patients were grouped randomly with 31 cases in each group .The con-trol group was treated with conventional submandibular approach for fracture fixation , and the observation group were treated by wearing buccal apparatus combined with intraoral incision minimally invasive treatment for bone fracture

  1. [Statistical study of mandibular resections].

    Science.gov (United States)

    Sidibe, C A; Dichamp, J; Razouk, O; Bertrand, J C; Guilbert, G

    1994-01-01

    A retrospective study of mandibular resections performed from 1980 to 1984 was conducted to evaluate age, sex, aetiology, etc. The number of mandibular resections appears to have declined at the Institute of Stomatology and Maxillofacial Surgery of the Pitié-Salpêtrière Hospital. Different factors are involved included early diagnosis, improved surgical techniques and better patient follow-up. Partial mandibular resections are increasingly performed (52% of the cases) compared with total resections. Finally, a better understanding of the pathologies involved, especially tumours, has led to an adaptation of the resection techniques to avoid extensive mutilations.

  2. Orthodontic Extraction of High-Risk Impacted Mandibular Third Molars in Close Proximity to the Mandibular Canal: A Systematic Review.

    Science.gov (United States)

    Kalantar Motamedi, Mahmood Reza; Heidarpour, Majid; Siadat, Sara; Kalantar Motamedi, Alimohammad; Bahreman, Ali Akbar

    2015-09-01

    Extraction of mandibular third molars (M3s) in close proximity to the mandibular canal has some inherent risks to adjacent structures, such as neurologic damage to teeth, bone defects distal to the mandibular second molar (M2), or pathologic fractures in association with enlarged dentigerous cysts. The procedure for extrusion and subsequent extraction of high-risk M3s is called orthodontic extraction. This is a systematic review of the available approaches for orthodontic extraction of impacted mandibular M3s in close proximity to the mandibular canal and their outcomes. The PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), DOAJ, Google Scholar, OpenGrey, Iranian Science Information Database (SID), Iranmedex, and Irandoc databases were searched using specific keywords up to June 2, 2014. Studies were evaluated based on predetermined eligibility criteria, treatment approaches, and their outcomes. Thirteen articles met the inclusion criteria. A total of 123 impacted teeth were extracted by orthodontic extraction and 2 cases were complicated by transient paresthesia. Three types of biomechanical approaches were used: 1) using the posterior maxillary region as the anchor for orthodontic extrusion of lower M3s, 2) simple cantilever springs attached to the M3 buttonhole, and 3) cantilever springs tied to a bonded orthodontic bracket on the M3 plus multiple-loop spring wire for distal movement of the M3. Osteo-periodontal status of M2s also improved uneventfully. Despite the drawbacks of orthodontic extraction, removal of deeply impacted M3s using the described techniques is safe with regard to mandibular nerve injury and neurologic damage. Orthodontic extraction is recommended for extraction of impacted M3s that present a high risk of postoperative osteo-periodontal defects on the distal surface of the adjacent M2 and those associated with dentigerous cysts. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by

  3. Ankylosis of temporomandibular joints after mandibular distraction osteogenesis in patients with Nager syndrome: Report of two cases and literature review.

    Science.gov (United States)

    Wu, Cheng Chun; Sakahara, Daisuke; Imai, Keisuke

    2017-10-01

    Nager syndrome, also known as Nager acrofacial dysostosis, was first described by Nager and de Reynier in 1948. The patients commonly present with micrognathia, and a preventive tracheostomy is necessary when there are symptoms of upper airway obstruction. Mandibular distraction osteogenesis is considered as an effective procedure, which not only improves micrognathia but also minimizes the chances of tracheostomy. However, mandibular distraction osteogenesis has some complications such as relapse, teeth injury, infection, and injury of the temporomandibular joints (TMJs). In this study, the author reported two patients with Nager syndrome who suffered from ankylosis of TMJs after mandibular distraction osteogenesis. In addition, a comprehensive literature review of post-distraction ankylosis of TMJs in patients with Nager syndrome was performed. Few studies demonstrated the condition of TMJs after mandibular distraction osteogenesis, and three studies were identified from the review. One study reported ankylosis of bilateral coronoid processes, in which coronoidectomies were necessary. Another study reported the use of prostheses to replace the ankylosed joints in a patient who had undergone many surgeries of the joints, such as gap arthroplasties, reconstructions with costochondral grafts, etc. One other study raised the concept of unloading the condyles during the mandibular distraction to prevent subsequent ankylosis. It seems that multiple factors are related to the ankylosis of TMJs after mandibular distraction osteogenesis in patients with Nager syndrome. Prevention of post-distraction ankylosis of the joints is important because the treatment is difficult and not always effective. We should conduct more studies about protection of the joints during mandibular distraction in the future. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Mandibular morphology of adults with skeletal classⅢmalocclusion and mandibular deviation analysed by CBCT%骨性Ⅲ类错伴下颌偏斜成人下颌骨形态的CBCT研究

    Institute of Scientific and Technical Information of China (English)

    王密; 于美清; 刘俊; 董福生; 卢海燕; 胡骁颖; 陈文静; 马文盛

    2014-01-01

    Objective:To analyse the asymmetry of mandibular of adults with skeletal classⅢmalocclusion and mandibular deviation using cone-beam computerized tomography(CBCT).Methods:20 adults with skeletal classⅢmalocclusion and mandibular deviation (deviation group)and 20 adults with individual normal occlusion(normal group)were included.CBCT slices were taken for each sub-ject.INVIVO 5 software was used to make 3D reconstruction and location marks for line distance and volume measurements of mandi-ble and condyle.Results:The measurements of the mandibular ramus length,mandibular total length,hemi-mandibular volume, mandibular ramus volume,posterior part of mandibular body length,condylar unit length,angular unit length,body unit length and an-gular angle in deviation group were significantly different between 2 sides(P<0.05).Compared with the normal group,differences of the asymmetry of mandibular ramus length,mandibular total length,hemi-mandibular volume,mandibular ramus volume,posterior part of mandibular body length,angular angle,condylar unit length and body unit length between 2 sides in deviation group were sig-nificantly different(P<0.05).Conclusion:In adults with skeletal classⅢmalocclusion and mandibular deviation deviated condylar and mandibular ramus are smaller than those of the nondeviated;the posterior part of mandibular body is slightly asymmetric while the anterior part of mandibular body is almost symmetric.%目的:用锥体束CT(CBCT)资料分析骨性Ⅲ类错!伴下颌偏斜成人患者下颌骨的形态特征。方法:纳入骨性Ⅲ类错!伴下颌偏斜的成人患者20例作为偏斜组,个别正常!20例为正常!组。进行CBCT扫描,用INVIVO 5软件对下颌骨进行三维重建,定位标记点,对测量值进行统计分析。结果:正常!组两侧测量值无统计学差异(P>0.05)。偏斜组中偏斜侧下颌升支长度、体积、下颌骨总长度、体积、下颌体后半部分长度、髁突

  5. Removal of Deeply Impacted Mandibular Molars by Sagittal Split Osteotomy

    Directory of Open Access Journals (Sweden)

    Erol Cansiz

    2016-01-01

    Full Text Available Mandibular third molars are the most common impacted teeth. Mandibular first and second molars do not share the same frequency of occurrence. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction; these are called kissing molars. In some cases, a supernumerary fourth molar can be seen as unerupted and, in this case, such a supernumerary, deeply impacted fourth molar is seen neighboring kissing molars. The extraction of deeply impacted wisdom molars from the mandible may necessitate excessive bone removal and it causes complications such as damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. This case report describes the use of the sagittal split osteotomy technique to avoid extensive bone removal and protect the inferior alveolar nerve during surgical extruction of multiple impacted teeth.

  6. Relationship between the condyle and adjacent structures in double temporomandibular joint view using panorama

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chang Yul; Kim, Jae Duk [Chosun Univ. Dental School, Gwangju (Korea, Republic of)

    2001-12-15

    To investigate the ability of double TMJ view by multifunctional panorama to view the bony components and the space of the temporomandibular joint. Ten dry skulls fitted with resin shims over the caricular surface of the condyle were used to reproduce the temporomandibular joint space. Fine metal wires were attached to the three portions of contours of the condylar head and the articular eminence. With 10 dry skulls and 20 cases having TMJ dysfunction, double TMJ views by multifunctional panorama (Planmeca 2002 Proline CC) and transcranial views were taken, analyzed from the anatomical view point, and compared statistically in view of the widths of the posterior joint space and the condylar head. In double TMJ view, the supero-anterior part of the condyle represented the lateral 1/3, the most superior part represented center portion, and the posterior part medial 1/3 of the condyle. In maximum mouth opening, no other structures were statistically with the condyle in double TMJ view. In double TMJ view, petrous bone was moderately superimposed with the superior part of the condyle. The tendency of reduction in the posterior joint space appeared in the side of TMJ dysfunction compared with the normal side. The posterior joint spaces in double TMJ view were statistically wider (p<0.05) than those in transcranial view. The correlation coefficient was 0.5179 between the widths of the posterior joint spaces in two radiographic views. Double TMJ view can be substituted for transcracial view in evaluating the TMJ dysfunction.

  7. Aggressive juvenile mandibular fibromatosis.

    Science.gov (United States)

    Ivanov, Georgi P; Atanasov, Dimitar T; Anavi, Beniamin L

    2013-01-01

    Aggressive juvenile fibromatosis of the jawbones is a rare tumor presenting as infiltrative mass with unpredictable evolution. We report herein a 17-year-old student with a 6-month history of radiologically proven resorption of a part of the mandible, lingual displacement of tooth 34 and malocclusion. Alveolar ridge resorption and three dark-brown foci in the bone were seen after the tooth was extracted. Histological study showed the tumor tissue to have a bundle-like structure; immunohistochemically it was positive for vimentin, smooth muscle actin, beta-catenin, Ki-67 (5%), and negative for desmin and cytokeratin 34bE12. The golden standard in the diagnostics of desmoid fibromatoses is the nuclear or membrane expression of beta-catenin, which is found in 90% of the cases. Differential diagnosis include mandibular fibroma, well-differentiated fibrosarcoma, fibrosing histiocytoma, and infiltration from adjacent soft-tissue tumor. Aggressive juvenile fibromatosis should be managed by radical excision. Local recurrences are not rare, but metastases do not develop. In rare cases this type of fibromatosis has been known to regress spontaneously. Aggressive fibromatosis is a diagnostic challenge, since it remains in the grey zone between benign and malignant lesions of the oral cavity.

  8. Treatment of mandibular prognathism.

    Science.gov (United States)

    Chang, Hong-Po; Tseng, Yu-Chuan; Chang, Hsin-Fu

    2006-10-01

    Mandibular prognathism (MP) or skeletal Class III malocclusion with a prognathic mandible is one of the most severe maxillofacial deformities. Facial growth modification can be an effective method of resolving skeletal Class III jaw discrepancies in growing children with dentofacial orthopedic appliances including the chincup, face mask, maxillary protraction combined with chincup traction and the Fränkel functional regulator III appliance. Orthognathic surgery in conjunction with orthodontic treatment is required for the correction of adult MP. The two most commonly applied surgical procedures to correct MP are sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy. Both procedures are suitable for patients in whom a desirable occlusal relationship can be obtained with a setback of the mandible, and each has its own advantages and disadvantages. In bilateral SSRO, the intentional ostectomy of the posterior part of the distal segment can offer long-term positioned stability. This may be attributable to reduction of tension in the pterygomasseteric sling that applies force in the posterior mandible. While various environmental factors have been found to contribute to the development of MP, heredity plays a substantial role. The relative contributions of genetic and environmental components in the etiology of MP are unclear. The recent identification of the genetic susceptibilities to MP constitutes the first step toward understanding the molecular pathogenesis of MP. Further studies in molecular biology are needed to identify the gene-environment interactions associated with the phenotypic diversity of MP and the heterogenic developmental mechanisms thought to be responsible for them.

  9. Mandibular midline distraction osteogenesis.

    Science.gov (United States)

    Botzenhart, Ute Ulrike; Végh, András; Jianu, Rodica; Gedrange, Tomasz

    2013-12-01

    In orthodontics, bone structure, its density and dimensions play an essential role by explaining limitations in magnitude, size and extent of tooth movement. Severe anterior crowding is one of the most frequently encountered dental malocclusions. Its therapy is mostly limited by lack of basal and alveolar bone and it often involves tooth extractions. Mandibular midline distraction osteogenesis is a method of natural bone generation and also a treatment option to achieve space regaining in a much-reduced lower jaw with distinctive frontal place deficit and severe anterior crowding, without sacrificing permanent teeth. McCarthy and Guerrero were of the first researchers reporting on this method applied on human lower jaws and they increased clinical interest in this approach. Although this method has been clinically used ever since, many questions concerning effects on bone regeneration speed, bone quality, tooth movement into regenerated area, periodontal health and long-time stability of treatment outcomes have not been sufficiently investigated. This overview should present the current clinical and biological state of knowledge about bone gain and tooth movement through regenerate bone. Furthermore it should encourage interest in further research on this topic.

  10. Stress distribution in the temporomandibular joint after mandibular protraction: a 3-dimensional finite element method study. Part 1.

    Science.gov (United States)

    Gupta, Anurag; Kohli, Virender S; Hazarey, Pushpa V; Kharbanda, Om P; Gunjal, Amit

    2009-06-01

    This study was designed to evaluate patterns of stress generation in the temporomandibular joint after mandibular protraction, by using a 3-dimensional finite element method. The results of the initial investigation are reported here in Part 1. The effects of varying the construction bite are reported in Part 2. A 3-dimensional computer-aided design model was developed from the magnetic resonance images of a growing boy (age, 12 years), by using I-DEAS NX (version 11.0, Siemens PLM Software, Plano, Tex). The model simulated mandibular protraction, with 5 mm of sagittal advancement and 4 mm of vertical opening. Stress distributions on the condylar neck, the glenoid fossa, and the articular disc in the anteroposterior and mediolateral directions were assessed. Tensile stresses were located on the posterosuperior aspects and compressive stresses on the anterior and anterosuperior aspects of the condylar head. Tensile stresses were found in the posterior region of the glenoid fossa near the attachment of the posterior connective tissues. These results suggest that, on mandibular protraction, the mandibular condyle experiences tensile stresses in the posterosuperior aspect that might help explain condylar growth in this direction. Similarly, on the glenoid fossa, tensile stresses are created in the region of posterior connective tissues; this might be correlated with the increased cellular activity in this region. Further study with variable vertical heights of the construction bites is needed.

  11. Evaluating mandibular cortical index quantitatively.

    Science.gov (United States)

    Yasar, Fusun; Akgunlu, Faruk

    2008-10-01

    The aim was to assess whether Fractal Dimension and Lacunarity analysis can discriminate patients having different mandibular cortical shape. Panoramic radiographs of 52 patients were evaluated for mandibular cortical index. Weighted Kappa between the observations were varying between 0.718-0.805. These radiographs were scanned and converted to binary images. Fractal Dimension and Lacunarity were calculated from the regions where best represents the cortical morphology. It was found that there were statistically significant difference between the Fractal Dimension and Lacunarity of radiographs which were classified as having Cl 1 and Cl 2 (Fractal Dimension P:0.000; Lacunarity P:0.003); and Cl 1 and Cl 3 cortical morphology (Fractal Dimension P:0.008; Lacunarity P:0.001); but there was no statistically significant difference between Fractal Dimension and Lacunarity of radiographs which were classified as having Cl 2 and Cl 3 cortical morphology (Fractal Dimension P:1.000; Lacunarity P:0.758). FD and L can differentiate Cl 1 mandibular cortical shape from both Cl 2 and Cl 3 mandibular cortical shape but cannot differentiate Cl 2 from Cl 3 mandibular cortical shape on panoramic radiographs.

  12. A case of severe mandibular retrognathism with bilateral condylar deformities treated with Le Fort I osteotomy and two advancement genioplasty procedures

    Science.gov (United States)

    Nakamura, Masahiro; Matsumura, Tatsushi; Yamashiro, Takashi; Iida, Seiji; Kamioka, Hiroshi

    2016-01-01

    We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR. PMID:27896214

  13. Mandibular reconstruction in adults: a review.

    NARCIS (Netherlands)

    Goh, B.T.; Lee, S.; Tideman, H.; Stoelinga, P.J.W.

    2008-01-01

    Mandibular defects may result from trauma, inflammatory disease and benign or malignant tumours. Mastication, speech and facial aesthetics are often severely compromised without reconstruction. The goal of mandibular reconstruction is to restore facial form and function, implying repair of mandibula

  14. Effects of bioabsorbable miniplateversus miniature titanium fixation system on the stability of mandibular fractures%生物可吸收性微型接骨板与微型钛内固定系统对下颌骨骨折稳定性的影响

    Institute of Scientific and Technical Information of China (English)

    邱勋定

    2015-01-01

    BACKGROUND:Bioabsorbable miniplates have good achievements after implantation, which have similar effect to the miniature titanium fixation system. Due to its absorbability, the bioabsorbable miniplate cannot exist in the body for a long time, which cannot influence bone stresses, cannot result in bone tissue atrophy, and have fewer complications than traditional metal internal fixations. OBJECTIVE:To explore and analyze the effects of miniature titanium internal fixation systemversus bioabsorbable miniplates on fracture stability in patients with mandibular fractures. METHODS:Ninety patients with mandibular fractures admitted at the Department of Stomatology, Hainan General Hospital from January 2013 to May 2015 were enroled. Al the subjects were divided into two groups according to different internal fixations: miniature titanium group and bioabsorbable miniplate group. RESULTS AND CONCLUSION:At 3 months after internal fixation, the stability rate was significantly higher in the bioabsorbable miniplate group than the miniature titanium group. At 1 year after internal fixation, the range of motion of the processus condyloideus was significantly higher in the miniature titanium group than the bioabsorbable miniplate group. These findings suggest that the bioabsorbable miniplate and miniature titanium internal fixation system both have good clinical outcomes in the treatment of mandibular fractures. The miniature titanium internal fixation system is easy to use and has good stability; the bioabsorbable miniplate can reduce foreign body reaction and prevent osteoporosis, and it has an ideal stability in combination with intermaxilary traction. Therefore, what kind of internal fixations is selected should be determined based on the wilingness and conditions of patients.%背景:生物可吸收性微型接骨板植入后患者恢复较好,且效果与微型钛内固定相似,并且由于其可吸收性,不会作为异物长期存在体内,无需二次手术

  15. Mandibular remodeling measured on cephalograms. 1. Osseous changes relative to superimposition on metallic implants.

    Science.gov (United States)

    Baumrind, S; Ben-Bassat, Y; Korn, E L; Bravo, L A; Curry, S

    1992-08-01

    We report the results of a study aimed at quantifying remodeling of mandibular surfaces in a sample of growing children who represent those usually treated by orthodontists in the mixed and early adult dentition. The sample, 31 patients with metallic implants of the Björk-type, was monitored at annual intervals between 8 1/2 and 15 1/2 years of age. (Maxillary remodeling changes for the sample have been reported earlier.) The present article reports findings concerning changes at condyle, gonion, menton, pogonion, and point B as identified on lateral cephalograms. Data are reported in the Frankfort plane frame of reference with the cephalograms from different time points superimposed on the metallic implants. Mean displacement at condyle was larger than that at any other landmark and was similar in magnitude and direction to the observations of Björk when the difference in orientation of the vertical axis in the two studies is taken into account. The mean displacement of gonion was in an upward and backward direction at an angle of approximately 45 degrees to the Frankfort plane. Mean displacements at menton and pogonion were in a downward and backward direction but were very small. Mean displacement at point B was somewhat greater than that of menton and gonion, oriented in an upward and backward direction. Individual variation for most of the parameters measured was sufficiently large to warrant the inference that caution should be used when mean values are applied to the analysis of individual cases.

  16. Validation of a novel semi-automated method for three-dimensional surface rendering of condyles using cone beam computed tomography data

    NARCIS (Netherlands)

    Xi, T.; Loon, B. van; Fudalej, P.S.; Berge, S.J.; Swennen, G.R.J.; Maal, T.J.J.

    2013-01-01

    Morphological changes of the condyles are often observed following orthognathic surgery. In addition to clinical assessment, radiographic evaluation of the condyles is required to distinguish the physiological condylar remodelling from pathological condylar resorption. The low contrast resolution an

  17. Biomechanical comparison of osteosynthesis with poly‑L‑lactic acid ...

    African Journals Online (AJOL)

    2015-01-21

    Jan 21, 2015 ... Materials and Methods: Artificial intracapsular fractures were created with a steel disk ... were transmitted directly from the load cell to a computer that shows emergent results .... complex interactions of the mandibular condyle.

  18. Overwhelming hypercalcaemia in mandibular ameloblastoma.

    Science.gov (United States)

    Lo, Tom Edward Ngo; Villafuerte, Cesar Vincent; Acampado, Laura Trajano

    2014-10-17

    Ameloblastoma is considered to be a benign odontogenic tumour of epithelial in origin that is slow growing but recurrent and invasive in nature. Some of its features have been sources of debate among experts regarding its benign or malignant character. We report a case of a 20-year-old Filipino woman with right mandibular ameloblastoma presenting with overwhelming hypercalcaemia. Work ups for hypercalcaemia eventually revealed tumoral hypercalcaemia, which was initially controlled with intravenous bisphosphanate. The patient eventually underwent tumour excision and mandibular reconstruction, which totally corrected hypercalcaemia. This case will highlight the rare association of hypercalcaemia among patients with ameloblastoma.

  19. Anterior mandibular displacement and condylar growth. An experimental study in the rat

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    Tonge, E.A.; Heath, J.K.; Meikle, M.C.

    1982-10-01

    Anterior displacement of the mandible was produced in twenty-eight 1-month-old female rats by two methods: (1) cast-gold splints cemented to the maxillary incisor teeth and (2) a removable stainless steel mesh appliance worn 6 hours each day, during which time the animals were sedated. The controls were littermates without appliances and in the mesh group were also sedated. Animals in the splint group were killed after 24 hours, 1 week, and 1 month; those in the mesh group were killed after 24 hours and after 1 week. the condyles were removed and cultured for 24 hours in medium containing /sup 3/H-thymidine. One condyle from each animal was processed for routine histologic and autoradiographic study. The other was digested in phosphate-buffered saline containing RNA-ase and pronase, and the specific activity of /sup 3/H-thymidine incorporation expressed as dpm/microgramDNA. Anterior mandibular displacement produced by both methods failed to result in a significant increase in the incorporation of /sup 3/H-thymidine into explant DNA. In the 7-day mesh experiment, however, there was a significant increase in the DNA content of the condylar explants from the displacement group, suggesting an increase in the cell population. This finding should be treated with caution because of the small numbers of animals involved, but it indicates an important area for further study. Changes in the distribution of labeled cells within the proliferative zone (PZ) were also observed autoradiographically in the mesh group, but there was little to suggest that mandibular displacement was accompanied by a significant increase in cell division within the PZ. Remodeling changes affecting both the articular tissue and the subchondral bone were a characteristic feature of the 1-month bit plane group.

  20. Impact of functional mandibular advancement appliances on the temporomandibular joint - a systematic review

    Science.gov (United States)

    Ivorra-Carbonell, Laura; Montiel-Company, José-María; Almerich-Silla, José-Manuel; Paredes-Gallardo, Vanessa

    2016-01-01

    Background Although many orthodontists have no doubts about the effectiveness of functional appliances for mandibular advancement, the impact on the temporomandibular joint (TMJ) is still in dispute. The objective of this systematic review is to examine the main effects on the TMJ of using functional appliances, both in healthy patients and in patients with a pre-existing disorder. Material and Methods A systematic review of the literature was conducted in accordance with the PRISMA guidelines. Only systematic reviews, meta-analyses, randomized clinical trials (RCTs), case-control studies and cohort studies were included. A detailed language-independent electronic search was conducted in the Pubmed, Scopus, Cochrane Library and Embase databases. All studies published between 2000 and 2015 were included. Results A total of 401 articles were identified. Of these, 159 were duplicates and were excluded. On reading the title and abstract, 213 articles were excluded because they did not answer the research question, leaving a total of 29 articles. These articles were read and assessed. Following critical reading of the full text, eight articles were excluded: seven because they were considered of low quality and one because it published redundant data. As a result, 21 articles were included. Conclusions After treatment with functional appliances, the condyle was found to be in a more advanced position, with remodelling of the condyle and adaptation of the morphology of the glenoid fossa. No significant adverse effects on the TMJ were observed in healthy patients and the appliances could improve joints that initially presented forward dislocation of the disk. Key words:Temporomandibular joint, TMJ, orthodontic appliances, functional, mandibular advancement, herbst appliance, bionator. PMID:27475694

  1. [Surgical treatment of humerus condylar fracture].

    Science.gov (United States)

    Gorodnichenko, A I; Guseĭnov, T Sh; Uskov, O N

    2014-01-01

    55 patients with intra-articular condyles fractures of humerus were operated in terms 1998 to 2013 year in the Clinic of Traumatology and Orthopedics of the Presidential Administration. All patients were operated by using of perosseous osteosynthesis method with external fixing device design A.I. Gorodnichenko. Indications for osteosynthesis were open and closed fractures of C1,2,3 types accordingly to AO Classification. Closed, atraumatic and reliable fixation of bone fragments intensifies patients faster, improves their life quality, decreases time of hospitalization and minimizes complications rate. Fractures consolidation was achieved in all cases. It was observed such complications as soft tissue inflammatory around shafts in 4 (7.3%) observations. Long-term results were studied in 51 (92.7%) patients including 9 (17.6%) patients with excellent results, 24 (47.1%) patients with good results and 18 (35.3%) patients with satisfactory results. It was not detected unsatisfactory results. The method permits early reconstructive treatment of patients and improves functional results in case of condyles fractures. This preserves active moving function of damaged elbow from the first day after operation and during all period of treatment.

  2. Increased mandibular condylar growth in mice with estrogen receptor beta deficiency.

    Science.gov (United States)

    Kamiya, Yosuke; Chen, Jing; Xu, Manshan; Utreja, Achint; Choi, Thomas; Drissi, Hicham; Wadhwa, Sunil

    2013-05-01

    Temporomandibular joint (TMJ) disorders predominantly afflict women of childbearing age, suggesting a role for female hormones in the disease process. In long bones, estrogen acting via estrogen receptor beta (ERβ) inhibits axial skeletal growth in female mice. However, the role of ERβ in the mandibular condyle is largely unknown. We hypothesize that female ERβ-deficient mice will have increased mandibular condylar growth compared to wild-type (WT) female mice. This study examined female 7-day-old, 49-day-old, and 120-day-old WT and ERβ knockout (KO) mice. There was a significant increase in mandibular condylar cartilage thickness as a result of an increased number of cells, in the 49-day-old and 120-day-old female ERβ KO compared with WT controls. Analysis in 49-day-old female ERβ KO mice revealed a significant increase in collagen type X, parathyroid hormone-related protein (Pthrp), and osteoprotegerin gene expression and a significant decrease in receptor activator for nuclear factor κ B ligand (Rankl) and Indian hedgehog (Ihh) gene expression, compared with WT controls. Subchondral bone analysis revealed a significant increase in total condylar volume and a decrease in the number of osteoclasts in the 49-day-old ERβ KO compared with WT female mice. There was no difference in cell proliferation in condylar cartilage between the genotypes. However, there were differences in the expression of proteins that regulate the cell cycle; we found a decrease in the expression of Tieg1 and p57 in the mandibular condylar cartilage from ERβ KO mice compared with WT mice. Taken together, our results suggest that ERβ deficiency increases condylar growth in female mice by inhibiting the turnover of fibrocartilage.

  3. Maxillo Mandibular Fixation in Edentulous Scenarios: Combined MMF Screws and Gunning Splints.

    Science.gov (United States)

    Chaudhary, Zainab; Sharma, Rakesh; Krishnan, Sriram

    2014-06-01

    A fracture of the maxillary or mandibular bone requires the afflicted to undergo a maxillo mandibular fixation for the establishment of pre traumatic occlusion. This process is quiet tedious and consumes a considerable period of time before any surgical procedure can commence. Such a situation can be complicated in case the individual with maxillomandibular fracture has sparse or absent dentition; for such cases a splint is fabricated or an erstwhile existing denture is used for maintaining a vertical jaw proportion. Stabilizing such splints to the jaw requires various invasive approaches that can bring into harm's way, adjacent soft tissue vital structures. We describe here an innovative technique combining the time tested method of the "gunning splint" and the advanced minimally invasive MMF screws for obtaining closed reduction in edentulous jaw fractures.

  4. Magnetic Resonance Imaging in Pediatric Elbow Fractures

    Energy Technology Data Exchange (ETDEWEB)

    Pudas, T.; Hurme, T.; Mattila, K.; Svedstroem, E. [Univ. of Turku, (Finland). Depts. of Radiology and Pediatric Surgery

    2005-10-01

    Purpose: Magnetic resonance imaging (MRI) evaluation of pediatric elbow trauma with or without a visible fracture on radiography. Material and Methods: MRI was performed in the acute phase in 25 children with an elbow injury. Nine patients with an elbow effusion only on radiographs and 16 with a fracture or luxation seen on radiographs underwent subsequent MRI. No sedation was used. Results: MRI revealed eight occult fractures (89%) in seven out of nine patients who had only an effusion on radiographs. Based on MRI findings, septic arthritis was suspected in one patient. Two patients out of five with a supracondylar fracture on the radiograph had a cartilage lesion in the humerus. MRI depicted a 3-mm gap on the articular surface in two patients with a lateral condyle fracture, a more accurate fracture location in two patients than the radiographs, and an additional occult fracture in two patients. MRI showed a fracture not seen on radiographs in two of three patients with prior luxation. Conclusion: MRI is a sensitive and accurate method in the diagnosis of pediatric elbow injuries, especially when only an effusion is present on radiographs. Occult fractures are more common in pediatric patients with elbow injury than reported earlier.

  5. Concurrent or sequential tibial subchondral cystic lesions in 4 horses with medial femoral condyle subchondral cystic lesions.

    Science.gov (United States)

    Bonilla, Alvaro G; Bertone, Alicia L; Brokken, Matthew T; Santschi, Elizabeth M

    2016-12-01

    CASE DESCRIPTION 4 horses were examined because of signs of chronic hind limb lameness. CLINICAL FINDINGS 3 horses had a history of lameness for > 6 months; specific duration was unknown for 1 horse. On initial evaluation, grade 3 to 4 (on a scale from 1 to 5) hind limb lameness was present in all 4 horses. Radiography of the stifle joint of the affected limb revealed medial femoral condyle subchondral lucencies or subchondral cystic lesions (SCLs) in all 4 horses, medial femorotibial osteoarthritis in 3 horses, and medial tibial condyle SCLs in 3 horses. TREATMENT AND OUTCOME 2 horses were treated medically (stall rest and oral NSAID administration), and 2 horses were treated surgically by means of medial femoral transcondylar lag screw placement through the medial femoral condyle SCLs. The 2 horses treated medically did not improve and were euthanized. Necropsy confirmed the presence of medial femoral condyle and medial tibial condyle SCLs. Surgical treatment did not resolve the lameness in 1 horse with SCLs in the medial tibial condyle and medial femoral condyle, and euthanasia was performed 150 days after surgery. In the second horse, a medial tibial condyle SCL was evident on radiographs obtained 3 months after surgery; however, this was not addressed surgically, and signs of lameness resolved 11 months after surgery. CLINICAL RELEVANCE Results of this small case series suggested that SCLs in the medial tibial condyle can occur in association with SCLs of the medial femoral condyle, with a poor prognosis for return to athletic function in affected horses. Further investigation is indicated.

  6. 颌间牵引钉联合小型或微型钛板内固定修复颌骨骨折%Internal fixation with intermaxillary traction nail combined with small/mini-titanium plate in the treatment of mandibular fractures

    Institute of Scientific and Technical Information of China (English)

    胡超; 肖金刚; 胡文健; 王雯; 潘庆; 曾昕

    2016-01-01

    BACKGROUND:Mandibular fractures often harm patient’s work and life. Intermaxilary traction nail with smal/mini-titanium plate, relative to traditional dental arch splint combined with smal/mini titanium plate treatment alone, is characterized by short treatment time and good fixation effect, which can improve the maxilofacial dysfunction and promote the early completion of the treatment. OBJECTIVE:To explore the curative effect of intermaxilary traction nail with mini-titanium plateversus dental arch splint combined with smal/mini-titanium plate on mandibular fractures METHODS:Ninety cases of mandibular fractures hospitalized at the Department of Oral and Maxilofacial Surgery, Stomatological Hospital of Southwest Medical University in China from July 2011 to May 2015 were enroled in this study. These patients were equivalently randomized into control group subjected to dental arch splint combined with smal/mini-titanium plate and observation group subjected to intermaxilary traction nail with mini-titanium plate. Al the patients were folowed up for 4-6 months. Curative effects, including excelent and good rate and total efficiency, were compared between the two groups. Maxilofacial function and incidence of adverse reactions were observed and recorded, respectively, to analyze the experimental data and assess their clinical values. RESULTS AND CONCLUSION:The total efficiency and the maxilofacial function were significantly better in the observation group than the control group (P   目的:通过试验颌间牵引钉联合微型钛板内固定相对牙弓夹板联合小型或微型钛板治疗的优势,探究其对于颌骨骨折的疗效及其应用效果。  方法:选取2011年7月至2015年5月在西南医科大学附属口腔医院颌面外科住院治疗的颌骨骨折患者90例,随机分为对照组和观察组,每组各45例。对照组使用牙弓夹板联合小型或微型钛板内固定治疗,观察组采用颌间牵引钉

  7. Complicaciones de los tornillos de bloqueo intermaxilar en el tratamiento de las fracturas mandibulares Complications of self-tapping bone screws for maxillomandibular fixation in the treatment of jaw fracture

    Directory of Open Access Journals (Sweden)

    J. Molina Montes

    2008-08-01

    Full Text Available Durante la última década se ha introducido el tornillo de bloqueo intermaxilar como método de fijación maxilomandibular en el tratamiento de las fracturas de mandíbula. El propósito del estudio es evaluar las complicaciones de la técnica y la yatrogenia dental que derivan de su aplicación durante un periodo de 4 años. Se han revisado un