1/21. Assessment, documentation, and treatment of a developing facial asymmetry following early childhood injury.Prepubertal trauma is often implicated as the cause of asymmetric growth of the mandible. A series of photographs taken before and after early childhood injury to the orofacial complex illustrates the development of a three-dimensional dentofacial deformity in a patient. The diagnosis and combined surgical orthodontic treatment plan to correct the facial asymmetry and malocclusion are discussed.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/21. temporomandibular joint ankylosis: review of thirty-two cases.I have reviewed aetiology, sex, age at time of treatment, clinical features, radiographic findings, anaesthetic techniques, surgical treatment, complications, and results in 32 patients with ankylosis of the temporomandibular joint. Trauma and infection were the commonest causes of ankylosis: 50% and 41%, (n = 13), respectively. The 21-30 year age group had the most trauma cases. Twenty (63%) of the patients presented with bilateral ankylosis. Failing to do jaw-opening exercises was the main cause of relapse.- - - - - - - - - - ranking = 0.061919551265009keywords = jaw (Clic here for more details about this article) |
3/21. Non-free osteoplasty of the mandible in maxillofacial gunshot wounds: mandibular reconstruction by compression-osteodistraction.We have treated 33 young men with medium to large (3-8 cm) bony and soft tissue defects of the lower third of the face caused by gunshot wounds. After debridement, collapsing the proximal segments for primary approximation of soft and hard tissues and a closed osteotomy of a small fragment of mandible, we used an original compression-distraction device, designed in 1982 and tested during 1983 (analogous devices were absent at that time) to reposition the mandible and cause callus to form (during distraction) between the fragment and to use the remaining stumps of bone to fill in the defect. The soft tissues were repaired at the same time. Twenty-eight of the patients presented within a few hours of injury, and the remaining five had old injuries. The only complications were in the group with old injuries where four patients developed abscesses that required drainage, but these did not interfere with the process of osteogenesis. All 33 patients had good functional and aesthetic results within 3-4.5 months. The method allows a bloodless minimally traumatic procedure which can be carried out in one stage. The results compare very favourably with the classic methods of the treatment of mandibular gunshot injuries.- - - - - - - - - - ranking = 6.000489339303keywords = mandible, lower (Clic here for more details about this article) |
4/21. Reconstructive surgery for complex midface trauma using titanium miniplates: Le Fort I fracture of the maxilla, zygomatico-maxillary complex fracture and nasomaxillary complex fracture, resulting from a motor vehicle accident.maxillofacial injuries resulting from trauma can be a challenge to the Maxillo-Facial Surgeon. Frequent causes of these injuries are attributed to automobile accidents, physical altercations, gunshot wounds, home accidents, athletic injuries, work injuries and other injuries. Motor vehicle accidents tend to be the primary cause of most midface fractures and lacerations due to the face hitting the dashboard, windshield and steering wheel or the back of the front seat for passengers in the rear. Seatbelts have been shown to drastically reduce the incidence and severity of these injuries. In the united states seatbelt laws have been enacted in several states thus markedly impacting on the reduction of such trauma. In the philippines rare is the individual who wears seat belts. Metro city traffic, however, has played a major role in reducing daytime MVA related trauma, as usually there is insufficient speed in traffic areas to cause severe impact damage, the same however cannot be said for night driving, or for driving outside of the city proper where it is not uncommon for drivers to zip into the lane of on-coming traffic in order to overtake the car in front ... often at high speeds. Thus, the potential for severe maxillofacial injuries and other trauma related injuries increases in these circumstances. It is however unfortunate that outside of Metro Manila or other major cities there is no ready access to trauma or tertiary care centers, thus these injuries can be catastrophic if not addressed adequately. With the exception of Le Fort II and III craniofacial fractures, most maxillofacial injuries are not life threatening by themselves, and therefore treatment can be delayed until more serious cerebral or visceral, potentially life threatening injuries are addressed first. Our patient was involved in an MVA in Zambales, seen and stabilized in a provincial primary care center initially, then referred to a provincial secondary care center for further stabilization before his transfer to Manila and then ultimately to our Maxillo-Facial Unit. There was a two week-plus delay in the definitive management because of this. As a result of the delay, fibrous tissue and bone callus formation occurred between the various fracture lines, thus once definitive fracture management was attempted, it took on a more reconstructive nature. Hospital based Oral and Maxillo-Facial Surgeons are uniquely trained to manage all aspects of the maxillo-facial trauma, and their dental background uniquely qualifies them in functional restoration of lower and midface fractures where occlusion plays a most important role. Likewise, their training in clinical medicine which is usually integrated into their residency education (12 months or more) puts them in a unique position to comfortably manage the basic medical needs of these patients. In instances where trauma may affect other regions of the body, an inter-multi-disciplinary approach may be taken or consults called for. In this instance, an opthalmology consult was important. In fresh trauma, often seen in major trauma centers (i.e. overseas), a "Trauma Team" is on standby 24 hours a day, and is prepared to assess and manage trauma patients almost immediately upon their arrival in the ER. The trauma team is usually composed of a Trauma Surgeon who is a general surgeon with subspecialty training in traumatology who assesses and manages the visceral injuries, an Orthopedic Surgeon who manages fractures of the extremities, a Neurosurgeon for cerebral injuries and an Oral and Maxillo-Facial Surgeon for facial injuries. In some institutions, facial trauma call is alternated between the "three major head and neck specialty services", namely Oral and Maxillo-facial Surgery, otolaryngology-head & neck Surgery and Plastic & Reconstructive Surgery. (ABSTRACT TRUNCATED)- - - - - - - - - - ranking = 0.00048933930304707keywords = lower (Clic here for more details about this article) |
5/21. Malformation in the primary and permanent dentitions following trauma prior to tooth eruption: a case report.Dento-facial injuries that occur prior to the eruption of teeth in the primary dentition are rare, but can result in damage to the primary dentition. We report a rare case where an injury to the anterior maxilla and mandible of an infant prior to primary tooth eruption resulted in hypoplasia, displacement and impaction of the primary dentition and damage to a developing permanent tooth.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
6/21. Traumatic bone cyst--a case report.Traumatic bone cyst is an asymptomatic, slow growing, non expansile lesion commonly diagnosed during routine radiographic examination of the jaw bones. It is more frequently seen in young age, with predilection for anterior region of the mandible leading to a dramatic healing of the lesion. A typical case of traumatic bone cyst in a 12 year old girl is reported. A routine radiologic assessment of the patient with panoramic radiograph revealed a fairly large lesion in the anterior region of the mandible. On surgical exploration, clinical diagnosis was confirmed. Post operative successive radiograph shows progressive osseous healing.- - - - - - - - - - ranking = 2.061919551265keywords = mandible, jaw (Clic here for more details about this article) |
7/21. An unusual cause of locked jaw and its airway management.We describe the management of a patient impaled through the medial aspect of the left orbit by the brake lever of a mountain bike which immobilized her jaw by obstructing the right coronoid process of the mandible and blocked access to the mouth and trachea. The fire service used special equipment to cut out the rest of the bike from the handle bar. The patient with the penetrating brake lever attached to the handlebar in situ was transported to the hospital by rescue helicopter. The assessment and safe airway management and potential difficulties are discussed.- - - - - - - - - - ranking = 1.309597756325keywords = mandible, jaw (Clic here for more details about this article) |
8/21. Traumatic carotid cavernous sinus fistula due to a gun shot injury.A case of a traumatic carotid cavernous sinus fistula is presented, the result of a bullet passing through both condylar regions of the mandible. The fistula was occluded by a detachable balloon brought in place using endovascular techniques.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
9/21. The missing maxilla: restoring aesthetic balance with mandibular surgery.Traumatic loss of large portions of the maxilla remains uncommon. Reconstruction demands careful attention to both the anatomy of the primary deformity as well as the associated secondary changes if there is to be acceptable restoration of facial aesthetics and function. In concert with rebuilding the missing maxilla, reconstruction may frequently involve repositioning the apparently undisturbed mandible.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
10/21. North American Burkitt's lymphoma presenting with intraoral symptoms.A case is presented in which posterior tooth mobility and pain, bilateral intraoral swelling of the mandible, and anterior open bite following an incident of facial trauma were the presenting symptoms of a 4-year-old, white American male with Burkitt-type malignant lymphoma. Radiographic examination revealed multiple osteolytic lesions in the body of the mandible, with loss of osseous trabecular architecture, and generalized loss of lamina dura in both maxillary and mandibular arches. The patient also had bone marrow involvement at the time of diagnosis. Following the initial course of chemotherapy, the patient experienced a significant resolution of the bilateral mandibular swelling, anterior open bite, tooth mobility, and dental pain. Relapse occurred shortly after remission was achieved, with tumor metastasis to the central nervous system and testes. The tumor remained resistant to further chemotherapeutic treatments and radiation strategems. Because of renal and metabolic complications, Burkitt's lymphoma constitutes an oncologic emergency. If untreated, this rapidly growing tumor is fatal. Early interception and referral of these cases by the examining dentist is crucial.- - - - - - - - - - ranking = 2keywords = mandible (Clic here for more details about this article) |
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