Prevalence, treatment and complications of mandibular fractures

Year 2019, Volume: 44 Issue: 2, 369 - 377, 30.06.2019

Hüseyin Can Tükel , Mehmet Emre Benlidayı

https://doi.org/10.17826/cumj.469210

Cited By: 1

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.

Keywords

Mandible, maxillofacial, trauma

Mandibula kırıklarının prevalansı, tedavisi ve komplikasyonları

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.

Keywords

Mandibula, alt çene, kırık, fraktür, maksillofasiyal, travma

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