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Objectives Mandibular fractures, especially at the parasymphysis and angle, significantly affect the temporomandibular joint (TMJ) due to remodeling. This study assesses changes in condyle volume, morphology, and position after open reduction and internal fixation (ORIF) using 3D analysis methods. Materials and methods A retrospective study evaluated 16 patients (11 males, 5 females; mean age: 33.63 years) with parasymphysis fractures, categorized into isolated (PS-type) and those with angle involvement (A-type). Preoperative and postoperative CBCT scans (minimum 6-month follow-up) were analyzed. Volumetric, linear, and angular changes in the condyle were assessed on the fractured and non-fractured sides. Results Significant postoperative condylar volume increase was observed on both fractured ( p  = 0.0081) and non-fractured sides ( p  = 0.0453). In PS-type fractures, condylar volume ( p  = 0.0156) and height ( p  = 0.0352) significantly increased on the fractured side, with a marked inter-side volumetric difference ( p  = 0.0232). A-type fractures showed a significant increase in sagittal condylar position on the non-fractured side ( p  = 0.0078). No other parameters showed significant change across or within groups. Correlation analyses revealed no significant association between condylar volume change and patient age or follow-up time. Conclusion TMJ remodeling after ORIF varies by fracture type. Isolated parasymphysis fractures caused significant increases in condylar volume and height. Angle fractures involvement showed greater sagittal positional. These results highlight the impact of fracture location and mechanical force distribution on adaptive remodeling.

Condylar-base-associated multiple mandibular fractures are more prevalent than single ones. Direct trauma to mandibular symphysis, body or angle are prone to induce indirect condylar fracture. However, little is known about the effects of various rigid internal fixation modalities in condylar base for relevant multiple mandibular fractures, especially when we are confused in the selection of operative approach. Within the finite element analysis, straight-titanium-plate implanting positions in condylar base contained posterolateral zone (I), anterolateral zone (II), and intermediate zone (III). Von Mises stress (SS) in devices and bone and mandibular displacement (DT) were solved, while maximum values (SSmax and DTmax) were documented. For rigid internal fixation in condylar-base-and-symphysis fractures, I + II modality exhibited least SSmax in screws and cortical bone and least DTmax, I + III modality exhibited least SSmax in plates. For rigid internal fixation in condylar-base-and-contralateral-body fractures, I + III modality exhibited least SSmax in screws and cortical bone, I + II modality exhibited least SSmax in plates and least DTmax. For rigid internal fixation in condylar-base-and-contralateral-angle fractures, I + III modality exhibited least DTmax. The findings suggest that either I + II or I + III modality is a valid guaranty for rigid internal fixation of condylar base fractures concomitant with symphysis, contralateral body or angle fractures.

Background: Treating cases that require different surgical specialties requires high-level interdisciplinary coordination, and prioritization of the patient's needs, which is nearly impossible in a war zone. Aim: To document the case of a woman who was diagnosed with multiple fractures from an explosive injury sustained during the October 2023 war in Gaza. Methods: The woman underwent 3 surgical operations, internal fixation for the rib fracture, internal fixation of the left humerus, and fixation of the mandible fracture. She was hospitalized for nearly one month in 2 admission intervals—14 days at the surgical department and 16 days at the intensive care unit. Result: After prolonged interdisciplinary management, recurrent admissions and multiple operations, the patient recovered significantly well. Conclusion: This case highlights the significance of a multidisciplinary approach to managing these types of injuries, and how a severe polytrauma patient can recover when provided with appropriate care in spite of the conflict.

Background Mandibular condyle fractures (MCFs) are common injuries, often resulting from trauma and leading to functional complications. Treatment approaches remain debated, with extracorporeal fixation emerging as a potential alternative to conventional methods. This study explores the effectiveness and outcomes of this technique to guide clinical decision-making. Materials and methods A comprehensive search was conducted across PubMed, EMBASE, and BVS (VHL) for studies published until August 2024. The review included observational studies and clinical trials that assessed postoperative complications following extracorporeal fixation in MCFs. Results Thirty-one studies, comprising 436 participants, were included. Data were extracted on trauma etiology, fracture classification, surgical approaches, and complications such as condylar resorption, which was the most common (18.58%). The studies varied in surgical techniques, with submandibular (40.62%) and retromandibular (37.5%) accesses being the most common. Osteosynthesis materials such as miniplates, screws, and wires were frequently used. Follow-up durations ranged from immediate post-operative periods to 15 years. The quality assessment revealed fair to moderate study quality, with observational studies generally showing methodological limitations, such as sample size issues and heterogeneity in surgical technique and follow-up. Despite concerns about condylar resorption and temporomandibular joint dysfunction, most studies reported that these complications did not significantly affect function or occlusion. Conclusions Extracorporeal fixation of MCFs offers a promising alternative in cases with limited condylar access where conventional methods may fail. Despite a higher risk of condylar resorption, studies suggest minimal long-term functional impairment. This technique remains viable for complex fractures. However, robust clinical trials are needed to evaluate long-term outcomes, particularly regarding resorption and postoperative recovery, given their potential to affect mandibular function, occlusion, and temporomandibular joint health.

Introduction Facial bone fractures triggered by low-height falls are rare in toddlers, while severe intracranial injuries resulting from minor trauma are extremely rare. Case Herein, we report the case of a 2-year-old girl who fell from a baby chair, striking her chin, who rapidly developed impaired consciousness 3 h later. The patient subsequently presented with a mandibular fracture and acute obstructive hydrocephalus due to a traumatic isolated subarachnoid hemorrhage in the posterior cranial fossa. She was successfully treated with ventricular drainage, which achieved a favorable outcome. Conclusion Maxillofacial trauma and head injuries are closely associated. Even in minor cases of maxillofacial trauma, vigilant monitoring and prompt intervention are crucial to prevent fatal outcomes in toddlers.

Objectives Previous finite element analyses (FEA) have shown promising results for using two titanium screws in treating mandibular condylar head fractures but limited mechanical stability of a two-screw osteosynthesis with magnesium screws. Given the potential benefits of magnesium screws in terms of biocompatibility and resorption, this study aimed to compare two- and three-screw osteosynthesis solutions for a right condylar head fracture (AO CMF type p) with magnesium screws with a FEA. Materials and methods A previously validated finite element model simulating a 350 N bite on the contralateral molars was used to analyze von Mises stress within the screws, fragment deformation, and fracture displacement. All screws were modeled with uniform geometric specifications mirroring the design of Medartis MODUS ® Mandible Hexadrive cortical screws. Results The three-screw configuration demonstrated lower values for all three parameters compared to the two-screw scenario. There was a 30% reduction in maximum von Mises stress for the top screw and a 46% reduction for the bottom screw. Conclusions Fracture treatment with three magnesium screws could be a valuable and sufficiently stable alternative to the established treatment with titanium screws. Further studies on screw geometry could help improve material stability under mechanical loading, enhancing the performance of magnesium screws in clinical applications. Clinical relevance The use of magnesium screws for osteosynthesis of mandibular condylar head fractures offers the benefit of reducing the need for second surgery for hardware removal. Clinical data is needed to determine whether the advantages of resorbable screw materials outweigh potential drawbacks in condylar head fracture treatment.

Background Osteomyelitis secondary to mandibular fracture surgery is rare and complete surgical debridement of necrotic infected tissues is an optimal treatment for it. Subsequent reconstruction is required for bone defect caused by operation. Autogenous, allograft and synthetic bone graft substitutes have become widespread in bone defect treatment. Distraction osteogenesis (DO) was also applied in bone defect reconstruction, even it wasn’t conventional therapy in jaw. Case presentation Here we report a case of a 40-year-old aged man who presented with chronic swelling and pain on the right mandibular masseteric region after mandibular angle and Le Fort II fracture surgery. In six weeks after surgery, CBCT images showed that the fracture ends hadn’t heal and the fracture gap had widened significantly. The clinical diagnosis of the patient was right mandibular angle osteomyelitis. After controlling the symptoms of pain and infection with local rinses and systemic antibiotic therapy, the patient underwent segmental resection of the infected bone and DO reconstruction for bone defect simultaneously. Encouragingly, well bone healing and normal occlusion restoration was observed finally. Conclusions DO could be a valuable alternative therapy to bone grafts for bone defect, even in the case of infection.

Mandibular condylar fractures can lead to facial asymmetry, malocclusion, and temporomandibular joint instability. To minimize the risk of these issues, endoscopic‐assisted reduction techniques were developed. Nevertheless, the confined working space inherent in endoscopic procedures poses challenges, especially in cases with unstable fracture sites, movable plates, and screws. To solve this dilemma, we developed a novel surgical technique using long plate for condylar fracture fixation. “Long Plate Technique” involves a long plate being stabilized via the submandibular incision site, with screws inserted through the trocar to affix the titanium plate onto the superior condylar segment from the tragus incision site. A total of 98 patients were included in this study. The overall average operation time was 365 min. Specifically, the average operation time for the group treated with closed reduction and intermaxillary fixation was 250 min, for Group B cases treated with short plate open reduction and intermaxillary fixation was 429 min, and for Group C treated with long plate open reduction and intermaxillary fixation was 413 min. The utilization of the Long Plate Technique provides a secure and efficient operation technique that can lessen the stress on surgeons during the operation.

Our study aims to estimate the prevalence of surgical site infections (SSI) following open reduction and internal fixation (ORIF) for mandibular fractures and to determine the effect of potential moderators on it. A systematic literature search (Medline and Scopus databases) was conducted independently by two reviewers. The pooled prevalence with 95% confidence intervals was estimated. Quality assessment as well as outlier and influential analysis were performed. Additionally, subgroup and meta-regression analysis were conducted in order the effect of categorical and continuous variables on the estimated prevalence to be investigated. In total, seventy-five eligible studies (comprising a sum of 5825 participants) were included in this meta-analysis. The overall prevalence of SSI following ORIF for mandibular fractures was estimated as high as 4.2% (95% CI 3.0–5.6%) with significant heterogeneity between studies. One study was identified to be critically influential. In the subgroup analysis, the prevalence was 4.2% (95% CI 2.2–6.6%) among studies conducted in Europe, 4.3% (95% CI 3.1–5.6%) among studies conducted in Asia and higher among those conducted in America (7.3%) (95% CI 4.7–10.3%). It is important for healthcare professionals to be aware of the etiology of these infections, despite the relatively low rate of SSI in these procedures. However, further, well-designed prospective and retrospective studies need to be conducted in order this issue to be fully clarified.

Background Maxillofacial fractures occur in a significant proportion worldwide and can occur as an isolated injury or in combination with other severe injuries including cranial, spinal, and upper and lower body injuries requiring prompt diagnosis with possible emergency interventions. The epidemiology of facial fractures varies with regard to injury type, severity, and cause and depends on the population studied. Hence, understanding of these factors can aid in establishing clinical and research priorities for effective treatment and prevention of these injuries. Materials and methods In this present retrospective study, we provide a comprehensive overview regarding cranio-maxillofacial trauma on 3611 patients to assist the clinician in assessment and management of this unique highly specialized area of traumatology. A preformed pro forma was used to analyze the medical records of patients treated for facial trauma in The Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai. The distribution according to age, gender, etiology, type of injury, time interval between accident and treatment, loss of consciousness, facial bones involved, pattern of fracture lines, treatment offered, and postoperative complications were recorded and evaluated. Results We inferred male patients sustained more injuries mostly in the third decade of age. Road traffic accidents were the most common cause of injury. Mandible was the most commonly fractured bone in the facial skeleton. Soft tissue injuries occurred more in road traffic accidents and upper lip was the commonest site of injury. Conclusion Our study provides insights into the epidemiology of facial injuries and associated factors and can be useful not only in developing prevention strategies but also for grading the existing legal regulations and also for framing a more effective treatment protocol.