The evaluation of alveolar fractures of trauma patients in Iran

A Clinical Guide to Dental Traumatology, 2007

I njuries to the teeth and the supporting alveolar bone may often go undiagnosed in the hospital emergency room because of the urgency of other associated critical injuries or the lack of adequate training to evaluate these injuries. Displaced alveolar fractures and associated dental injuries are to be considered a subacute emergency because the timing of treatment affects the prognosis of the involved teeth. 8 Whenever possible, these injuries should be treated without delay to improve the prognosis of the teeth, reduce pain, and restore function. Alveolar fractures often occur with concomitant dental and soft tissue injuries and sometimes with facial bone fractures. These fractures result in injury not only to the supporting bone, but also to the pulps and periodontal ligaments of the involved teeth. Treatment of these injuries requires immediate reduction, fixation and immobilization, and long-term follow-up and restoration of the injured teeth. Every effort should be made to preserve alveolar bone and restorable teeth. The mucogingival tissue must be properly reapproximated to prevent an unesthetic deformity that may be difficult to reconstruct at a later date. An endodontic assessment of all injured teeth should be planned along with the prosthetic rehabilitation of the fractured or avulsed teeth. Pulpal necrosis, root resorption, loss of bone and teeth, and malocclusion are some of the complications of alveolar fractures. This chapter will discuss the terminology, recognition, evaluation, management, and endodontic implications of alveolar fractures with examples of some clinical scenarios. Awareness of these basic principles will help the dentist to provide timely care and create an understanding of when to promptly refer these injuries. EPIDEMIOLOGY AND ETIOLOGY Alveolar fractures are usually reported in conjunction with dental injuries and facial fractures, making it difficult to estimate their incidence. In an investigation of patients coming

Trauma Monthly, 2019

Background: The management of maxillofacial injuries is one of the most common challenges in the healthcare field as surgeons, who treat these patients have additional responsibilities in terms of esthetic reconstruction as well as restoration of the patient's appearance and function. Objectives: The aim of the present study was to evaluate the epidemiology and etiology of trauma at Buali Hospital of Tehran during 2008 to 2016. Methods: In this retrospective study, the files of all the trauma patients (n = 293) that had referred to Buali Hospital were investigated, and demographic data and etiologic factors were extracted. Radiographs were analyzed with regards to fracture patterns. The results were statistically analyzed using the SPSS 22 software. Results: The mean age was 29.18 ± 14.74 years in males and 34.48 ± 19.81 years in females. Fractures were more frequent at ages between 21 and 30 years (39.9%) and less common among 71-to 84-year-olds (2.4%). Most patients were males (78.8%). Of all 474 fractures in 293 patients, zygomatic fractures were the most common fractures (18.6%), while Lefort III in the maxilla was the least common type (1.3%). The main cause of fracture was motor vehicle accidents (51.5%), whereas workplace injuries were uncommon (11.4%). Conclusions: According to the results, fractures often occur in males in the third decade of life due to their roles in the community. In the current study, similar to other studies carried out in developing countries, the main cause of fractures was motor vehicle accidents. Most of the patients were treated by open reduction. The most frequent side effect was sensory disorders.

Journal of Clinical and Experimental Dentistry, 2014

Intrusive luxation is a type of recognizable luxation injury represented by a deeper axial displacement of the tooth toward the alveolar bone. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. The aim of this case report was to present the management of severe dental trauma and later restoration following IADT. A 20-year-old patient was presented after fainting at home four hours before, resulting in a dento-alveolar trauma. Clinical examinations revealed a traumatic intrusion, in 1.2, 1.1 and 2.1, uncomplicated crown fractures in 1.1 and 2.1 and a complicated crown-root fracture in 2.2. The diagnosis was confirmed with CBCT. Following IADT protocol, the emergency treatment consisted of the surgical repositioning and semi-rigid splinting using orthodontic wire-composite, replacing the buccal bone plate, and postoperative instructions to the patient regarding oral hygiene. After 2 weeks the root canal treated and filled with fiberglass posts in 1.2, 1.1, 2.1 and 2.2. Splint was removed after 4 weeks and the IADT reassessment protocol followed, with revisions at 6-8 weeks, 6 months, a year and annual reviews for 5 years. A year after the treatment, the traumatized teeth were restored with minimally invasive preparations of feldspathic ceramic. Esthetics and function were recorded with a 3-year follow-up period. Faus-Matoses V, Martínez-Viñarta M, Alegre-Domingo T, Faus-Matoses I, Faus-Llácer VJ. Treatment of multiple traumatized anterior teeth associated with an alveolar bone fracture in a 20-year-old patient: A 3-year follow up. J Clin Exp Dent. 2014;6(4):e425-9.

Journal of Emergency Practice and Trauma, 2021

Objective: The purpose of the current study is to determine the prevalence and pattern of maxillofacial trauma. Methods: This is a cross sectional study of maxillofacial trauma cases treated in the referral trauma center of south of Iran. Data of 264 patients were extracted from patients’ records and analyzed. Data included patient’s demographics, injury mechanism, types of maxillofacial injuries, Injury Severity Score (ISS), associated injuries, length of hospital stay and outcome. Binary logistic regression by backward method was applied to determine the effects of independent variables on mortality odds ratio. Results: 85.23% of patients were males and of all patients 87.5% survived. The mean of age was 34.95 ± 16.51. The commonest cause of maxillofacial injury was road traffic accidents (86.31%). The median of ISS was 20.39± 10.24 and patients aged 30-39 years had the highest ISS. Overall, the most common maxillofacial injuries were orbital (59.47%, n=157) followed by maxillary ...

Dental research journal

Background: Fracture, is discontinuity of anatomical bone relations. Commonly, a maxillofacial fracture occurs after trauma but the etiology and pattern of this entity is different amongst countries. The aim of this study was to clarify the main causes of this entity in Yazd to increase public and professional awareness to prevent more injuries and subsequent consequences. Materials and Methods: This retrospective cross-sectional study consisted of 194 patients admitted in public hospitals in Yazd, Iran. Variables such as age, gender, cause of accidents, site of fracture and treatment method were noted and recorded in a questionnaire filled during hospitalization of these patients. Causes of accident were classified by 6 reasons such as accident by car and motorcycle, fighting and violence, falls, sports and occupational injuries. The site of fractures, including mandible, maxilla, nasal, frontal and orbital were considered. The data were analyzed using descriptive analysis. Results: The results showed that maxillofacial fractures are more prevalent in male than females (69% versus 31%). The Most sites of fractures were nasal bone (79%). The majority of people with maxillofacial fractures were in the age ranged between 20-29 years and the main reason of maxillofacial fractures was motorcycle accident. Conclusion: According to our result, most sites of fractures were in nasal bone. The main cause of maxillofacial fractures was motorcycle accident. However, in each age range the most common cause of accident was different.

European Journal of Trauma and Emergency Surgery, 2019

Introduction We aimed to describe the prevalence and pattern of maxillofacial trauma in Qatar. Methods This is a retrospective study of trauma registry data at Hamad General Hospital during the period from January 2011 to December 2014. The study included all traumatic maxillofacial patients who underwent CT scan and were admitted during the study period. Results A total of 1187 patients with maxillofacial injuries were included in the study and 18.5% of all trauma admissions were related to maxillofacial injuries. Young age and males were predominantly affected. Mechanisms of injury were mainly traffic-related and fall. Orbital injuries were the commonest followed by maxillary injuries. The median and range face abbreviated injury score (AIS) was 2 [1–3] with 66% had a score of 2. Maxillofacial fractures were frequently associated with traumatic brain injuries. One out of five patients was managed with surgery and had median length of stays in ICU and hospital 5 and 7 days, respect...

International journal of surgery science, 2022

Background: Since the face is the most visible part of the human body, it has great aesthetic significance. It also regulates crucial processes including speech and chewing. Method: The investigation was done at Alshaheed Ghazi Alhariri Specialized Surgery Teaching Hospital and Medical City Complex. Two researchers reviewed 398 oral and maxillofacial surgery patients' hospital records and radiographs from January 2022 to January 2023. The same portion treated all facial fractures. Fractures were characterized by age, sex, anatomical location, and injury aetiology. Anatomical position was utilized to diagnose mandibular fractures by Ivy and Curtis. Maxillary fractures were anatomically identified and classified using Le Fort. Open reduction and internal fixation or closed therapy were employed to classify the fractures. Results: In a study of 398 patients, road traffic accidents were the most common cause of injury, leading to various fractures with mandibular fractures being the most frequent. The majority of these fractures were treated using open reduction and internal fixation. The study highlighted the prevalence and treatment approaches for different types of facial fractures. Conclusion: The findings showed that transport accidents caused the most face fractures at Alshaheed Ghazi Alhariri specialized surgical teaching hospital / medical city complex. Sex and aetiology affect men and women's roles and facial trauma features. Men were more impacted than women, particularly young individuals (20-29 years), with the mandibular bone broken first, followed by the zygomatic and nasal bones.

Craniomaxillofacial Trauma & Reconstruction, 2014

Although there is a worldwide increase in maxillofacial trauma incidence; the pattern and etiology of these injuries varies from one country to another depending on socioeconomic, cultural, and environmental factors. This study aims to realize the epidemiological characteristics of maxillofacial fractures in our department. A retrospective cross-sectional study of all facial trauma patients admitted to our department during 2009 to 2012. Patients’ data including gender, age, etiology of trauma, the pattern and demographic distribution of fractures of maxillofacial skeleton, and associated injuries were analyzed and compared with previously published data. The chi-square test was used with a p value of less than 0.05, which was considered statistically significant. There is a significant increase in maxillofacial fractures incidence in the past 2 years than former ones. There is a male predominance with highest incidence in the age group of 20 to 40 years. Road traffic accident is th...

Dental traumatology : official publication of International Association for Dental Traumatology, 2015

The aim of this study was to retrospectively investigate the incidence and associated factors of dental trauma in patients with maxillofacial fractures at the VU Medical Center in Amsterdam. Data from 707 patients who were treated surgically for maxillofacial fractures were evaluated. The data were collected retrospectively from patient files and other available databases. The data collected included date of fracture, age, gender, type of fracture, and injured teeth. Of the total 707 patients, 164 patients (23.2%) presented dental injuries associated with facial fractures. Mandibular condylar fractures, mandibular parasymphyseal fractures, Le Fort fractures, and mandibular body fractures were found to be significantly more associated with dental injury. Zygomatic arch or zygomatic complex fractures were significantly less associated with dental injury. Women had a significant higher risk of facial fractures with dental injuries than men. The maxilla demonstrated the highest incidenc...

DR. P. R. YADAV, 2019

The epidemiology of maxillofacial trauma varies in geographic zones and different countries. Population, lifestyle (culture, social, and economic status), and concentration can affect the control of maxillofacial trauma. So, in this study, the epidemiological data and treatment plan concerning maxillofacial trauma were evaluated and analyzed. This study isa retrospective study which performed on 57 patients who suffer from maxillofacial trauma and suspected facial bone fractures. All patients were presented to the emergency department in three different hospitals and specialist dental center in Karbala city from the period of January 2017 till January 2018. Epidemiological data sheet (checklist) and medical records were depended to achieve the study aims. Based on t-test, statistical analysis was done. Based on accidents causes,the ratio of Road Traffic Accidents (RTA) n=38 (66.67%), Assault n=9 (15.79%), Falls n=7(12.28%), War Injury n=1(1.75%), and other injury n=2 (3.51%) of the samples. In other classify that depend on the anatomical sites, the mandible was the most common fractured bone in RTA, Assaults, and falls. The previous studies and this study that discussed the epidemiology of maxillofacial traumas show various etiologic factors, demographic properties, causes of injuries and fracture patterns probably due to social, cultural and the policy of governmental especially in roads and traffic rules.