Fixation of mandibular fractures: a tincture of science.
ABSTRACT To critically review the literature regarding the fixation of mandibular fractures to gain direction on which type of fixation is indicated in which clinical setting.
A critical review of the literature based on computer searches using the Medline and Cochrane databases. The years searched were 1987 to 2002. Keywords used were: mandibular, fracture, fixation and osteosynthesis.
Eight hundred and thirty-four citations were obtained of which 127 were for case reports, orthognathic surgery or veterinary science. Thirty-nine citations dealt with non-clinical testing and four examined cost related to different treatment modalities. Six hundred and sixty-four citations were for articles reporting clinical experience, technical variations, comparative series, or proposed treatment protocols. Only a handful of papers reported studies sufficiently well designed to permit conclusions to be drawn on the relative success of various treatment approaches.
The published literature on the fixation of mandibular fractures falls well short of that required for evidence based surgery.
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ABSTRACT: The mandible is the second most commonly fractured part of the maxillofacial skeleton because of its position and prominence. Over the past three decades, many different techniques and approaches have been described in the literature to surgically correct facial fractures. The present study has attempted to study the role of bone grafts in open reduction and internal fixation of mandibular fractures. Fourteen patients with mandibular fracture were considered for the study from August 2006 to August 2008. Autologous bone grafts were used for rigid fixation of these fractures in all the cases. Patients presenting with unilateral fractures of the body of the mandible were considered and enrolled for rigid internal fixation using autologous bone grafts. Fourteen patients were included in the study of which 11 were males and the rest were females. The average age at presentation was 30.4 years (18–62 years). Unicortical outer table parietal calvarial bone graft was used in all patients. The size of bone graft harvested ranged from 55 × 20 mm to 60 × 20 mm. Autologous calvarial bone graft harvested from the outer table appears to be a safe, cheaper, and effective alternative to miniplates in selected cases of mandibular fracturesEuropean Journal of Plastic Surgery 06/2010; 33(3-DOI: 10.1007/s00238-010-0407-7):163-167. DOI:10.1007/s00238-010-0407-7
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ABSTRACT: The aim of the present study was to evaluate the effect of a pulsed electromagnetic field on the healing of mandibular fractures. Pulsed electromagnetic fields have been shown to accelerate healing of fractures of the long bones. A total of 12 patients with mandibular fractures were selected for the present study. Each patient was treated by closed reduction using maxillomandibular fixation (MMF) and was assigned into 1 of 2 equal groups. The fracture sites of group A only were exposed to pulsed electromagnetic fields (PEMF) 2 hours daily for 12 days, after 2 weeks postoperatively the MMF was removed. For group B (control group), the MMF was removed at 4 weeks postoperatively. The effectiveness of the 2 treatment modalities was evaluated clinically and radiographically using computerized densitometry. The data were statistically analyzed. After releasing the MMF, a bimanual mobility test of the fractured segments showed stability of the segments in all cases. An insignificant difference was found between the mean bone density values of the 2 groups at all study intervals. In contrast, the percentage of changes in bone density of the 2 groups revealed that group A had insignificant decreases at the 15th postoperative day and a significant increase 30 days postoperatively compared with group B. From the present limited series of patients, PEMF stimulation might have a beneficial effect on the healing of mandibular fractures treated with closed reduction. However, additional research, using randomized controlled trials, should be conducted to ascertain its effectiveness compared with other treatment modalities.Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 06/2011; 69(6):1708-17. DOI:10.1016/j.joms.2010.10.013 · 1.28 Impact Factor