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Prevalence, treatment and complications of mandibular fractures

Year 2019, Volume: 44 Issue: 2, 369 - 377, 30.06.2019
https://doi.org/10.17826/cumj.469210

Abstract

Purpose: The purpose of this study was to review and analyze the prevalence, treatment, and complications of mandibular fractures managed by the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Çukurova University between March 2015 and March 2017

Materials and Methods: Mandibular fractures were sorted by etiology and fracture location. Open reduction and internal fixation of mandibular fractures were performed using 2.0mm or 2.4mm fixation systems. Closed reduction of fractures was performed using arch bars, intermaxillary fixation screws or wire-composite splints. The following complications were recorded: Temporary paresthesia, permanent paresthesia, malocclusion, infection, temporomandibular joint disorder, plate exposure and root damage.

Results: The mean patient age was 32.8±(13.8). Males constituted 77.4%(n=65) and females constituted 22.6%(n=19) of the patients. The most common cause of mandibular fractures in this study was interpersonal violence (27 cases,32.1%), followed by road traffic accidents(22 cases, 26.2%) and falls(21 cases,25%). The least common cause of fractures was sports accident(6 cases,7.1%). The most common fracture localization was the condyle(27,24.5%), followed by the angle (24,21.8%), body (19,17.3%), symphysis/parasymphysis (18, 16.4%) and alveolar bone (17,15.5%). Fifty patients were treated by ORIF (59.5%), 29 patients were treated by closed reduction (34.5%). Complications in varying severity were observed in 25(29.7%) patients. The most common complication in this study was temporary paresthesia(13.1%) followed by TMD(6.0%). Other complications were seen infrequently.

Conclusion: It is important to follow contemporary trends to understand how different centers manage their patients in different socio-economic regions and different levels of clinical facilities/resources. The incidence and causes of mandibular fractures may reflect the trauma patterns within the community, which is important for conducting better health policy strategies.


References

  • 1. Simsek S, Simsek B, Abubaker AO, Laskin DM. A comparative study of mandibular fractures in the United States and Turkey. Int J Oral Max Surg. 2007;36(5):395-7. doi: 10.1016/j.ijom.2006.11.010. PubMed PMID: WOS:000246907500004.
  • 2. Samieirad S, Tohidi E, Shahidi-Payam A, Hashemipour MA, Abedini A. Retrospective study maxillofacial fractures epidemiology and treatment plans in Southeast of Iran. Med Oral Patol Oral. 2015;20(6):E729-E36. doi: 10.4317/medoral.20652. PubMed PMID: WOS:000369435500013.
  • 3. Samieirad S, Aboutorabzade MR, Tohidi E, Shaban B, Khalife H, Hashemipour MA, Salami HR. Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study. Med Oral Patol Oral. 2017;22(5):E616-E24. doi: 10.4317/medoral.21809. PubMed PMID: WOS:000422866700014.
  • 4. Ogundare BO, Bonnick A, Bayley N. Pattern of mandibular fractures in an urban major trauma center. J Oral Maxil Surg. 2003;61(6):713-8. doi: 10.1053/joms.2003.50118. PubMed PMID: WOS:000183272700018.
  • 5. Krishnaraj S, Chinnasamy R. A 4-year retrospective study of mandibular fractures in a south Indian city. J Craniofac Surg. 2007;18(4):776-80. doi: DOI 10.1097/scs.0b013e318069005d. PubMed PMID: WOS:000248513100013.
  • 6. Erol B, Tanrikulu R, Gorgun B. Maxillofacial fractures. Analysis of demographic distribution and treatment in 2901 patients (25-year experience). J Craniomaxillofac Surg. 2004;32(5):308-13. doi: 10.1016/j.jcms.2004.04.006. PubMed PMID: 15458673.
  • 7. Ellis E, 3rd, Moos KF, el-Attar A. Ten years of mandibular fractures: an analysis of 2,137 cases. Oral Surg Oral Med Oral Pathol. 1985;59(2):120-9. PubMed PMID: 3856795.
  • 8. Atilgan S, Erol B, Yaman F, Yilmaz N, Ucan MC. Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey. J Appl Oral Sci. 2010;18(1):17-22. doi: Doi 10.1590/S1678-77572010000100005. PubMed PMID: WOS:000276524900004.
  • 9. Yasar M, Bayram A, Dogan M, Sagit M, Kaya A, Ozcan I, Mutlu C. Retrospective Analysis of Surgically Managed Maxillofacial Fractures in Kayseri Training and Research Hospital. Turk Arch Otorhinolaryngol. 2016;54(1):5-9. doi: 10.5152/tao.2016.1501. PubMed PMID: 29392008; PMCID: PMC5782976.
  • 10. Eriksson L, Willmar K. Jaw fractures in Malmo 1952-62 and 1975-85. Swed Dent J. 1987;11(1-2):31-6. PubMed PMID: 3473708.
  • 11. Champy M, Lodde JP, Schmitt R, Jaeger JH, Muster D. Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg. 1978;6(1):14-21. PubMed PMID: 274501.
  • 12. Paes JV, de Sa Paes FL, Valiati R, de Oliveira MG, Pagnoncelli RM. Retrospective study of prevalence of face fractures in southern Brazil. Indian J Dent Res. 2012;23(1):80-6. doi: 10.4103/0970-9290.99045. PubMed PMID: 22842255.
  • 13. Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(1):28-34. doi: 10.1016/j.tripleo.2005.07.023. PubMed PMID: 16831669.
  • 14. Kamulegeya A, Lakor F, Kabenge K. Oral Maxillofacial Fractures Seen at a Ugandan Tertiary Hospital: A Six-Month Prospective Study. Clinics. 2009;64(9):843-8. doi: 10.1590/S1807-59322009000900004. PubMed PMID: WOS:000270232700004.
  • 15. Elgehani RA, Orafi MI. Incidence of mandibular fractures in Eastern part of Libya. Med Oral Patol Oral. 2009;14(10):E529-E32. PubMed PMID: WOS:000270845600008.
  • 16. Oikarinen K, Ignatius E, Kauppi H, Silvennoinen U. Mandibular fractures in northern Finland in the 1980s--a 10-year study. Br J Oral Maxillofac Surg. 1993;31(1):23-7. PubMed PMID: 8431409.
  • 17. Chrcanovic BR, Abreu MH, Freire-Maia B, Souza LN. 1,454 mandibular fractures: a 3-year study in a hospital in Belo Horizonte, Brazil. J Craniomaxillofac Surg. 2012;40(2):116-23. doi: 10.1016/j.jcms.2011.03.012. PubMed PMID: 21458284.
  • 18. Zix JA, Schaller B, Lieger O, Saulacic N, Thoren H, Iizuka T. Incidence, aetiology and pattern of mandibular fractures in central Switzerland. Swiss Med Wkly. 2011;141:w13207. doi: 10.4414/smw.2011.13207. PubMed PMID: 21618147.
  • 19. Bormann KH, Wild S, Gellrich NC, Kokemuller H, Stuhmer C, Schmelzeisen R, Schon R. Five-year retrospective study of mandibular fractures in Freiburg, Germany: incidence, etiology, treatment, and complications. J Oral Maxillofac Surg. 2009;67(6):1251-5. doi: 10.1016/j.joms.2008.09.022. PubMed PMID: 19446212.
  • 20. Erol B, Ozer N, Tanrikulu R, Gulsun B, Atay C. MAXILLO-FACIAL FRACTURES: RETROSPECTIVE STUDY OF THE 2308 CASES. Ulus Travma Acil Cerrahi Derg. 1998;4(3):162-7. doi: doi:.
  • 21. Ozgenel GY, Bayraktar A, Ozbek S, Akin S, Kahveci R, Ozcan M. [A retrospective analysis of 204 mandibular fractures]. Ulus Travma Acil Cerrahi Derg. 2004;10(1):47-50. PubMed PMID: 14752687.
  • 22. Türkiye Analiz: Takip Çalışması. SüRüCü Ve ÖN Koltuk Yolcularinin Emni̇Yet Kemeri̇ Kullanimi (accessed at 03.10.2018) Available from: http://www.trafik.gov.tr/SiteAssets/Yayinlar/Kitaplar/Emniyet_Kemeri_2016.pdf.
  • 23. Fridrich KL, Pena-Velasco G, Olson RA. Changing trends with mandibular fractures: a review of 1,067 cases. J Oral Maxillofac Surg. 1992;50(6):586-9. PubMed PMID: 1593318.
  • 24. Safdar N, Meechan JG. Relationship between fractures of the mandibular angle and the presence and state of eruption of the lower third molar. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(6):680-4. PubMed PMID: 7621022.
  • 25. Lamphier J, Ziccardi V, Ruvo A, Janel M. Complications of mandibular fractures in an urban teaching center. J Oral Maxillofac Surg. 2003;61(7):745-9; discussion 9-50. PubMed PMID: 12856243.
  • 26. Cabrini Gabrielli MA, Real Gabrielli MF, Marcantonio E, Hochuli-Vieira E. Fixation of mandibular fractures with 2.0-mm miniplates: review of 191 cases. J Oral Maxillofac Surg. 2003;61(4):430-6. doi: 10.1053/joms.2003.50083. PubMed PMID: 12684959.
  • 27. Olson RA, Fonseca RJ, Zeitler DL, Osbon DB. Fractures of the mandible: a review of 580 cases. J Oral Maxillofac Surg. 1982;40(1):23-8. PubMed PMID: 6950035.
  • 28. Teshome A, Andualem G, Tsegie R, Seifu S. Two years retrospective study of maxillofacial trauma at a tertiary center in North West Ethiopia. BMC Res Notes. 2017;10(1):373. doi: 10.1186/s13104-017-2670-1. PubMed PMID: 28789668; PMCID: PMC5549360.
  • 29. de Matos FP, Arnez MF, Sverzut CE, Trivellato AE. A retrospective study of mandibular fracture in a 40-month period. Int J Oral Maxillofac Surg. 2010;39(1):10-5. doi: 10.1016/j.ijom.2009.10.005. PubMed PMID: 19914802.
  • 30. Junior SM, Santos SE, Kluppel LE, Asprino L, Moreira RW, de Moraes M. A comparison of motorcycle and bicycle accidents in oral and maxillofacial trauma. J Oral Maxillofac Surg. 2012;70(3):577-83. doi: 10.1016/j.joms.2011.03.035. PubMed PMID: 21665346.
  • 31. Munante-Cardenas JL, Facchina Nunes PH, Passeri LA. Etiology, treatment, and complications of mandibular fractures. J Craniofac Surg. 2015;26(3):611-5. doi: 10.1097/SCS.0000000000001273. PubMed PMID: 25643329.

Mandibula kırıklarının prevalansı, tedavisi ve komplikasyonları

Year 2019, Volume: 44 Issue: 2, 369 - 377, 30.06.2019
https://doi.org/10.17826/cumj.469210

Abstract

Amaç:Bu çalışmanın amacı
Çukurova Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi
tarafından 2015-2017 yılları arasında tedavi edilen mandibula kırıklarının
prevalansı, tedavisi ve komplikasyonlarını incelemektir. 

Gereç ve Yöntem:Mandibula kırıkları
etiyolojiye ve kırıkların lokalizasyonuna göre sınıflandırıldı. Açık redüksiyon
ve internal fiksasyon 2.0mm veya 2.4mm fiksasyon sistemleri kullanılarak
yapıldı. Kapalı redüksiyonda ark-bar, intermaksiller fiksasyon vidaları veya
tel-kompozit splint kullanıldı. Aşağıdaki komplikasyonlar kaydedildi: Geçici
parestezi, kalıcı parestezi, maloklüzyon, enfeksiyon, temporomandibular eklem
bozukluğu,fiksasyon materyalinin açığa çıkması ve kök hasarı.

Bulgular:Ortalama hasta yaşı
32,8±(13,8) idi. Erkekler, çalışmaya dahil edilen vakaların %77.4(n = 65),
kadınlar ise % 22.6(n=19) 'sını oluşturdu. Bu çalışmada mandibula kırıklarının
nedenleri sırasıyla kişilerarası şiddet(27 olgu,%32,1), trafik kazaları(22
olgu,%26,2) ve düşme (21 olgu,% 25) olarak bulundu. Kırıkların en nadir nedeni
spor kazasıydı (6 olgu,% 7,1). En yaygın kırık lokalizasyonu sırasıyla
kondil(27,%24.5), ardından angulus (24,% 21,8), korpus (19,%17.3), simfiz /
parasimfiz (18,% 16,4) ve alveolar kemik (17, %15,5) idi. Elli hasta açık
redüksiyon (% 59,5) ile tedavi edilirken, 29 hasta kapalı redüksiyon (%34.5)
ile tedavi edildi. Üç hasta (%3,6) tedavi görmedi. Hastaların 25'inde (%29,7)
değişen derecelerde komplikasyonlar gözlendi. Bu çalışmada en sık rastlanan komplikasyon
geçici parestezi (%13,1) olmuştur. Bunu temporomandibular eklem rahatsızlığı
(%6,0) izlemiştir. Diğer komplikasyonlar seyrek görülmüştür.

Sonuç:Farklı merkezlerin
hastalarını farklı sosyo-ekonomik bölgelerde ve farklı klinik imkan / kaynak
düzeylerinde nasıl yönettiğini anlamak ve güncel tedavi yöntemlerini takip
etmek önemlidir. Mandibular kırıkların görülme sıklığı ve nedenleri, toplum
içindeki travma modellerini yansıtması açısından daha iyi sağlık politikası
stratejileri yürütmek için yol gösterici olabilir.

References

  • 1. Simsek S, Simsek B, Abubaker AO, Laskin DM. A comparative study of mandibular fractures in the United States and Turkey. Int J Oral Max Surg. 2007;36(5):395-7. doi: 10.1016/j.ijom.2006.11.010. PubMed PMID: WOS:000246907500004.
  • 2. Samieirad S, Tohidi E, Shahidi-Payam A, Hashemipour MA, Abedini A. Retrospective study maxillofacial fractures epidemiology and treatment plans in Southeast of Iran. Med Oral Patol Oral. 2015;20(6):E729-E36. doi: 10.4317/medoral.20652. PubMed PMID: WOS:000369435500013.
  • 3. Samieirad S, Aboutorabzade MR, Tohidi E, Shaban B, Khalife H, Hashemipour MA, Salami HR. Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study. Med Oral Patol Oral. 2017;22(5):E616-E24. doi: 10.4317/medoral.21809. PubMed PMID: WOS:000422866700014.
  • 4. Ogundare BO, Bonnick A, Bayley N. Pattern of mandibular fractures in an urban major trauma center. J Oral Maxil Surg. 2003;61(6):713-8. doi: 10.1053/joms.2003.50118. PubMed PMID: WOS:000183272700018.
  • 5. Krishnaraj S, Chinnasamy R. A 4-year retrospective study of mandibular fractures in a south Indian city. J Craniofac Surg. 2007;18(4):776-80. doi: DOI 10.1097/scs.0b013e318069005d. PubMed PMID: WOS:000248513100013.
  • 6. Erol B, Tanrikulu R, Gorgun B. Maxillofacial fractures. Analysis of demographic distribution and treatment in 2901 patients (25-year experience). J Craniomaxillofac Surg. 2004;32(5):308-13. doi: 10.1016/j.jcms.2004.04.006. PubMed PMID: 15458673.
  • 7. Ellis E, 3rd, Moos KF, el-Attar A. Ten years of mandibular fractures: an analysis of 2,137 cases. Oral Surg Oral Med Oral Pathol. 1985;59(2):120-9. PubMed PMID: 3856795.
  • 8. Atilgan S, Erol B, Yaman F, Yilmaz N, Ucan MC. Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey. J Appl Oral Sci. 2010;18(1):17-22. doi: Doi 10.1590/S1678-77572010000100005. PubMed PMID: WOS:000276524900004.
  • 9. Yasar M, Bayram A, Dogan M, Sagit M, Kaya A, Ozcan I, Mutlu C. Retrospective Analysis of Surgically Managed Maxillofacial Fractures in Kayseri Training and Research Hospital. Turk Arch Otorhinolaryngol. 2016;54(1):5-9. doi: 10.5152/tao.2016.1501. PubMed PMID: 29392008; PMCID: PMC5782976.
  • 10. Eriksson L, Willmar K. Jaw fractures in Malmo 1952-62 and 1975-85. Swed Dent J. 1987;11(1-2):31-6. PubMed PMID: 3473708.
  • 11. Champy M, Lodde JP, Schmitt R, Jaeger JH, Muster D. Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg. 1978;6(1):14-21. PubMed PMID: 274501.
  • 12. Paes JV, de Sa Paes FL, Valiati R, de Oliveira MG, Pagnoncelli RM. Retrospective study of prevalence of face fractures in southern Brazil. Indian J Dent Res. 2012;23(1):80-6. doi: 10.4103/0970-9290.99045. PubMed PMID: 22842255.
  • 13. Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(1):28-34. doi: 10.1016/j.tripleo.2005.07.023. PubMed PMID: 16831669.
  • 14. Kamulegeya A, Lakor F, Kabenge K. Oral Maxillofacial Fractures Seen at a Ugandan Tertiary Hospital: A Six-Month Prospective Study. Clinics. 2009;64(9):843-8. doi: 10.1590/S1807-59322009000900004. PubMed PMID: WOS:000270232700004.
  • 15. Elgehani RA, Orafi MI. Incidence of mandibular fractures in Eastern part of Libya. Med Oral Patol Oral. 2009;14(10):E529-E32. PubMed PMID: WOS:000270845600008.
  • 16. Oikarinen K, Ignatius E, Kauppi H, Silvennoinen U. Mandibular fractures in northern Finland in the 1980s--a 10-year study. Br J Oral Maxillofac Surg. 1993;31(1):23-7. PubMed PMID: 8431409.
  • 17. Chrcanovic BR, Abreu MH, Freire-Maia B, Souza LN. 1,454 mandibular fractures: a 3-year study in a hospital in Belo Horizonte, Brazil. J Craniomaxillofac Surg. 2012;40(2):116-23. doi: 10.1016/j.jcms.2011.03.012. PubMed PMID: 21458284.
  • 18. Zix JA, Schaller B, Lieger O, Saulacic N, Thoren H, Iizuka T. Incidence, aetiology and pattern of mandibular fractures in central Switzerland. Swiss Med Wkly. 2011;141:w13207. doi: 10.4414/smw.2011.13207. PubMed PMID: 21618147.
  • 19. Bormann KH, Wild S, Gellrich NC, Kokemuller H, Stuhmer C, Schmelzeisen R, Schon R. Five-year retrospective study of mandibular fractures in Freiburg, Germany: incidence, etiology, treatment, and complications. J Oral Maxillofac Surg. 2009;67(6):1251-5. doi: 10.1016/j.joms.2008.09.022. PubMed PMID: 19446212.
  • 20. Erol B, Ozer N, Tanrikulu R, Gulsun B, Atay C. MAXILLO-FACIAL FRACTURES: RETROSPECTIVE STUDY OF THE 2308 CASES. Ulus Travma Acil Cerrahi Derg. 1998;4(3):162-7. doi: doi:.
  • 21. Ozgenel GY, Bayraktar A, Ozbek S, Akin S, Kahveci R, Ozcan M. [A retrospective analysis of 204 mandibular fractures]. Ulus Travma Acil Cerrahi Derg. 2004;10(1):47-50. PubMed PMID: 14752687.
  • 22. Türkiye Analiz: Takip Çalışması. SüRüCü Ve ÖN Koltuk Yolcularinin Emni̇Yet Kemeri̇ Kullanimi (accessed at 03.10.2018) Available from: http://www.trafik.gov.tr/SiteAssets/Yayinlar/Kitaplar/Emniyet_Kemeri_2016.pdf.
  • 23. Fridrich KL, Pena-Velasco G, Olson RA. Changing trends with mandibular fractures: a review of 1,067 cases. J Oral Maxillofac Surg. 1992;50(6):586-9. PubMed PMID: 1593318.
  • 24. Safdar N, Meechan JG. Relationship between fractures of the mandibular angle and the presence and state of eruption of the lower third molar. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(6):680-4. PubMed PMID: 7621022.
  • 25. Lamphier J, Ziccardi V, Ruvo A, Janel M. Complications of mandibular fractures in an urban teaching center. J Oral Maxillofac Surg. 2003;61(7):745-9; discussion 9-50. PubMed PMID: 12856243.
  • 26. Cabrini Gabrielli MA, Real Gabrielli MF, Marcantonio E, Hochuli-Vieira E. Fixation of mandibular fractures with 2.0-mm miniplates: review of 191 cases. J Oral Maxillofac Surg. 2003;61(4):430-6. doi: 10.1053/joms.2003.50083. PubMed PMID: 12684959.
  • 27. Olson RA, Fonseca RJ, Zeitler DL, Osbon DB. Fractures of the mandible: a review of 580 cases. J Oral Maxillofac Surg. 1982;40(1):23-8. PubMed PMID: 6950035.
  • 28. Teshome A, Andualem G, Tsegie R, Seifu S. Two years retrospective study of maxillofacial trauma at a tertiary center in North West Ethiopia. BMC Res Notes. 2017;10(1):373. doi: 10.1186/s13104-017-2670-1. PubMed PMID: 28789668; PMCID: PMC5549360.
  • 29. de Matos FP, Arnez MF, Sverzut CE, Trivellato AE. A retrospective study of mandibular fracture in a 40-month period. Int J Oral Maxillofac Surg. 2010;39(1):10-5. doi: 10.1016/j.ijom.2009.10.005. PubMed PMID: 19914802.
  • 30. Junior SM, Santos SE, Kluppel LE, Asprino L, Moreira RW, de Moraes M. A comparison of motorcycle and bicycle accidents in oral and maxillofacial trauma. J Oral Maxillofac Surg. 2012;70(3):577-83. doi: 10.1016/j.joms.2011.03.035. PubMed PMID: 21665346.
  • 31. Munante-Cardenas JL, Facchina Nunes PH, Passeri LA. Etiology, treatment, and complications of mandibular fractures. J Craniofac Surg. 2015;26(3):611-5. doi: 10.1097/SCS.0000000000001273. PubMed PMID: 25643329.
There are 31 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research
Authors

Hüseyin Can Tükel 0000-0002-6723-0842

Mehmet Emre Benlidayı 0000-0002-6102-9136

Publication Date June 30, 2019
Acceptance Date December 5, 2018
Published in Issue Year 2019 Volume: 44 Issue: 2

Cite

MLA Tükel, Hüseyin Can and Mehmet Emre Benlidayı. “Prevalence, Treatment and Complications of Mandibular Fractures”. Cukurova Medical Journal, vol. 44, no. 2, 2019, pp. 369-77, doi:10.17826/cumj.469210.