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... Mаxillоfаciаl trаumа hаs becоme оne оf the mаjоr heаlth prоblems wоrldwide, аnd injury pаtterns vаry in different sоcieties [6,7]. The incidence vаries аccоrding tо geоgrаphicаl аreа аnd sоciоecоnоmic stаtus оf the pоpulаtiоn investigаted [8]. ...
... Аssаult аnd MVА аre the twо mаin cаuses оf mаxillоfаciаl injury wоrldwide [11]. Injuries аt mаxillоfаciаl regiоns stemming frоm MVА cоntinue tо be the leаding cаuse in mаny cоuntries [7,12]. It is knоwn thаt the incidence оf MVА is even higher in develоping cоuntries, which rаnged frоm 55.2 tо 91% аs repоrted in the literаture [13,18]. ...
... The rаtiо оf оur study wаs lоwer thаn 13:1 аs described by Mоаfiаn et аl in а study perfоrmed in Irаn [20]. These findings demоnstrаte а lаck оf estаblished pаttern аcrоss cultures [7]. The culturаl аnd sоciоecоnоmic vаlues оf pоpulаtiоn studied might influence the rаtes оf fаciаl frаctures in wоmen [11]. ...
... Trauma due to external causes represents one of the greatest challenges for public health services in different regions around the world (1)(2)(3). Every day in developed and developing countries, thousands of people are victims of interpersonal violence or are involved in traffic accidents, overburdening health services (1)(2)(3)(4). Trauma in the face, head and neck region is generally the most prevalent, the vast majority of which affect vulnerable groups of the population, involving an anatomical region that largely defines the perception of the individual's self-image and identity, often associated with persistent damage (5). Disorders of the maxillofacial complex resulting from trauma stand out from other types due to a high incidence and diversity of injuries, as well as being generally associated with a severe degree of morbidity, loss of function, and financial burden (6). ...
... In a study conducted in the United States, it was found that costs related to length of hospital stay and surgical treatment of facial fractures indicated an extensive consumption of hospital resources (7). In general terms, maxillofacial injury is a health problem that presents epidemiology, pathophysiology, morbidity and mortality investigated by several researchers (2)(3)(4). Its epidemiology can vary widely, and depends on several factors, including culture, socioeconomic status, and population density (1)(2)(3)(4)(5)(6)(7)(8). ...
... In general terms, maxillofacial injury is a health problem that presents epidemiology, pathophysiology, morbidity and mortality investigated by several researchers (2)(3)(4). Its epidemiology can vary widely, and depends on several factors, including culture, socioeconomic status, and population density (1)(2)(3)(4)(5)(6)(7)(8). ...
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Background: Trauma due to external causes represents one of the greatest challenges for public health services in different regions around the world. This study aimed to determine the prevalence of facial trauma, associated risk factors, and classification of body injuries in individuals who underwent forensic examination in a Brazilian center. Material and methods: Data were collected at the Ceará State Forensic Medicine unit in a 12-year period. Sociodemographic data related to the etiological agent and lesions resulting from the bodily injury were recorded. Results: Among 1,031 physical injury exams, physical aggression (p<0.001), male victims aged between 21 and 30 years (p<0.001), salaried workers (p<0.001), and soft tissue and dentoalveolar injuries were significant findings. Regarding aggression, domestic violence was prevalent (p<0.001), perpetrated by the victim's partner (p<0.001), using a blunt instrument during the aggression (p<0.001), and directly associated with soft tissue injury (p<0.001). In traffic accidents, the most common type was motorcycle accident (p<0.001), on weekdays (p=0.036), at nighttime (p=0.134), showing a significant association with bone fractures (p=0.001). Conclusions: Oral and maxillofacial injuries obtained from a Brazilian forensic science center were significantly associated with sociodemographic and etiological factors. Key words:Forensic dentistry, facial trauma, violence, public health.
... Even if the introduction of seat belts and the improvement of safety systems led to a significant reduction of injury severity and death after traffic accidence, they are still one of the major causes for maxillofacial injuries in adults [2,4]. Those injuries may result in a loss of function, disfiguration, psychological problems or even disability and death [5]. The assessment of facial injuries is often perceived as difficult by the ambulance. ...
... Nevertheless, this seems to apply for Germany/Central Europe only as other countries reported different major causes for maxillofacial injuries [10]. The given prevalence is similar if not slightly higher to those reported by others [5,17] whereas a recent publication showed concomitant injuries to the facial skull in about 39% of cases [8]. The injury pattern of severely injured patients after traffic accidents has changed for car/truck accidents only. ...
... For example, in Malaysia, motorcycle-related fatalities are reported to be three times higher than car fatalities, six times higher than pedestrian and 50 times higher than bus passenger fatalities [18]. Nevertheless, others analysed in 2008 that accidents involving automobiles were the most frequent cause [5,17]. In the developed countries, greater prevalence of facial trauma among victims of automobile accidents than among victims of motorcycle accidents may be due to the use of airbags, which, despite reducing the incidence and severity of injuries in general, may contribute to facial injuries. ...
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Objectives It was the aim of the study to analyse the prevalence of maxillofacial trauma (MFT) in severely injured patients after road traffic accidence (RTA) and to investigate associated factors. Materials and methods In a retrospective study, data from patients after RTA by the TraumaRegister DGU® from 1993 to 2014 were evaluated for demographical and injury characteristics. The predictor variable was mechanism of injury and the outcome variables were type of injury, severity and hospital resources utilization. Results During the investigation period, n = 62,196 patients were enclosed with a prevalence of maxillofacial injuries of 20.3% (MFT positive). The injury severity score of MFT-positive patients was higher than in the MTF-negative subgroup (27 ± 12.8 vs. 23.0 ± 12.7). If MFT positive, 39.8% show minor, 37.1% moderate, 21.5% serious and 1.6% severe maxillofacial injuries. Injuries of the midface occurred in 60.3% of MTF-positive patients. A relevant blood loss (> 20% of total blood volume) occurred in 1.9%. MFT-positive patients had a higher coincidence with cervical spine fractures (11.3% vs. 7.8%) and traumatic brain injuries (62.6% vs. 34.8%) than MFT-negative patients. There was a noticeable decrease in the incidence of facial injuries in car/truck drivers during the study period. Conclusions Every 5th patient after RTA shows a MFT and the whole trauma team must be aware that this indicates a high prevalence of traumatic brain and cervical spine injuries. Clinical relevance Even if sole injuries of the face are seldom life threatening, maxillofacial expertise in interdisciplinary trauma centres is strongly recommended.
... Brazil, 20 Malaysia, 21 The male/female ratio ranged from 3.4: 1 to 6: 1. The prevalent mean age in all centres analyzed corresponded to young people or adults. ...
... Multivariate statistical analysis was performed to investigate risk factors for maxillofacial injuries. Eleven risk factors were identified: victim's gender (P < 0.05), 21 age group (P < 0.05) (20.21), residence region (P < 0.05), 20 impact characteristics (P < 0.05), 22 increased net change in velocity due to collision (P < 0.05), 22 Epidemiological studies in different parts of the world indicate that RTAs are the main etiological factors of facial trauma and the specific interest has been directed towards the incidence and prevention of these lesions. [23][24][25][26][27][28][29][30][31][32][33][34] Maxillofacial injuries usually affect the middle third of the facial skeleton and mandible, especially soft tissues. ...
... The maxillofacial region is the most exposed part of the body and is prone to lesions, 4 which may occur alone or associated with multiple injuries in the head, chest, abdomen, spine and extremities, 7,8 along with psychological trauma. 35 The three studies selected for this review were conducted in 3 different countries and locations: Brazil, 20 Malaysia, 21 and the United States. 22 As for associated factors, there was high heterogeneity among studies, since there was no standardization about the way of categorizing the age groups, types of accidents and circumstances in which they occurred, making a meta-analysis impossible. ...
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Aim This study aimed to evaluate the scientific evidence regarding the risk factors for maxillofacial injuries among victims of traffic accidents. Method A systematic review of articles published until February 2017 was carried out in the following databases: PubMed, Web of Science, Scopus, and Cochrane Library. Studies were selected by two independent reviewers (ϰ = 0.841). The risk of bias in the selected studies was assessed using an adapted version of the Newcastle‐Ottawa Scale for observational studies. Results A total of 2703 records were found, of which only three articles fulfilled the inclusion criteria and were analyzed, including 422 244 patients. The male/female ratio ranged from 3.4: 1 to 6: 1. All eligible studies performed the multivariate statistical analysis. Eleven risk factors for maxillofacial traumas were identified: victim's gender (P < 0.05), age group (P < 0.05), residence region (P < 0.05), impact characteristics (P < 0.05), increased net change in velocity due to collision (P < 0.05), increase in occupant's height (P < 0.05), nonuse of protective equipment (P < 0.05), type of accident (P < 0.05), time of occurrence (P < 0.05), lesion severity (P < 0.05), and occurrence of concomitant lesions (P < 0.05). Conclusion The results suggest that sociodemographic characteristics, as well as those related to the collision patterns and circumstances of traffic accidents, may influence the occurrence of maxillofacial injuries. However, the results should be interpreted with caution due to the high heterogeneity among studies.
... from MVA continue to be the leading cause in many countries. 1,6 It is known that the incidence of MVA is even higher in developing countries, which ranged from 55.2 to 91% as reported in the literature. [7][8][9][10][11][12] MVA is the main etiology and the second cause of mortality, particularly in Southeast Asia. ...
... From the demographic data of maxillofacial trauma, it was shown that maxillofacial fractures were significantly more prevalent in men (538 males, 85.4%) compared with women (92 females, 14.6%). Male-to-female ratio was 5.8:1, a higher ratio compared with study by Fasola et al, Nobrega et al, and Bayan et al. 1,14,15 However, the ratio of our study was lower than 13:1 as described by Moafian et al in a study performed in Iran. 16 These findings demonstrate a lack of established pattern across cultures. ...
... 16 These findings demonstrate a lack of established pattern across cultures. 1 The cultural and socioeconomic values of population studied might influence the rates of facial fractures in women. 5 For work-related accidents, men tend to have a higher-risk job as compared with women. ...
Article
The aims of this study were to provide an overview of maxillofacial trauma and its relationship to patient's demographic data and alcohol consumption within the state of Sabah. It was a retrospective study of maxillofacial trauma cases treated by Oral and Maxillofacial Surgery Department, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, from January 1, 2009, until December 31, 2013. A total of 630 maxillofacial trauma cases were included. Details of the trauma were collected from patients' record, including patients' cause of injuries, injuries suffered, treatment indications, and treatment received. Patients' demographic data (age, gender), alcohol consumption in relation to causes, and type of maxillofacial injury were analyzed. There were 538 male (85.4%) and 92 female (14.6%) patients (ratio: 5.8:1), with mean age of 31.0 years. Most common causes of maxillofacial injury were motor vehicle accident (MVA; 66.3%), followed by fall (12.4%) and assault (11.6%). Motorcyclists made up more than half of the total cases (53.1%). Cases referred were primarily due to soft-tissue injury (458 cases). Other cases were dentoalveolar and maxillofacial bone fractures. Treatment provided for the fractures included open reduction and internal fixation (22.9%), closed reduction (28.7%), and conservative management (48.4%). Toilet and suturing were done for all patients with soft-tissue injury. Maxillofacial trauma is a major problem in Sabah. It affects mostly males in the age group of 21 to 30 years. Most of the MVA patients were motorcyclists. Mandibular fracture with parasymphysis involvement recorded the highest number. Most of the patients preferred conservative management, probably due to financial and logistic issue.
... Of course, the most important objects of study in performing such examinations are the victims (corpses or living persons). In general, these issues have been carefully studied by both domestic [11,22,23] and foreign authors [1,10,17,18,19,24,25]. Particular attention in cases of accidents was paid to comprehensive studies [1,3,4,5,7]. ...
... Particular attention in cases of accidents was paid to comprehensive studies [1,3,4,5,7]. However, in the study of injuries in victims of traffic accidents traditionally paid attention primarily to damage to the lower extremities (due to the action of the car bumper), torso, skull bones and brain [5,6,10,15,17,19,26]. Therefore, accordingly, in the forensic literature there are very few works related to other injuries received by victims of traffic accidents, in particular, injuries of the dental apparatus [3,8,12,20,24,25,27]. ...
Article
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Information about the differential diagnosis of human bodily injuries, which were formed when the body, wheel and bottom of a modern car came into contact with the body of a pedestrian; a person on the road surface, in the cabin of a modern car (driver and passengers), when a cyclist comes into contact with a car, in cases of combined types of car injury, is not enough. The purpose of the study is to increase the objectivity of forensic examinations by determining the criteria for assessing damage to the dental system in cases of the most common types of accidents: collision of moving vehicle with man; run over the body with a wheels or the bottom of vehicle; at an injury inside the vehicle on the basis of the analysis of morphological features and the mechanism of the specified damages. The archival materials of 130 forensic medical examinations of the municipal institution “Odessa Regional Bureau of Forensic Medical Examination” concerning victims of living persons and corpses as a result of traffic accidents that were accompanied by their injuries in the period 2015-2020 were used. The following research methods were used: anthropometric, morphometric, photographic, radiological, statistical. The article presents our own experience of improving the objectivity and provability of forensic examinations by determining the criteria for assessing damage to the dental system in cases of the most common types of vehicle: collision of moving vehicle with man; run over the body with a wheels or the bottom of vehicle; at an injury inside the vehicle on the basis of the analysis of morphological features and the mechanism of the specified damages. It is proved that according to the degree of gravity of physical injuries (health disorder or disability), damage to the dental apparatus in traffic accidents should be investigated only in cases of isolated injuries. In this case, fractures of the jaws, regardless of their nature, should be assessed as moderate injuries according to the criterion of long-term health disorders; Crown fractures, traumatic tooth dislocations, and soft tissue fatal wounds should be considered simple injuries that have caused short-term health disorders. Abrasions, bruises should be attributed to simple injuries. Thus, it is impractical to separately determine the severity of the injury of the dental system in cases run over the head with a wheels or the bottom of vehicle - in these cases, we always deal with gross, massive destruction of the bones of the skull.
... A study by Diallo, O.R., et al. [7] in Guinea found 39.36% of road accidents were motorcycle accidents. In Brazil, Nóbrega, L.M., et al. [13] found that motorcycle accidents accounted for 67.8% of all road accidents. However, in Madagascar Rakotoarivony, A.E., et al. [14] reported that motorcycle accidents had a lower incidence than car accidents with the former accounting for 29.3% while the later accounted for 63.8% respectively. ...
... This could be explained by the failure of riders to use helmets and the lack of external protection for victims of motorcycle road accident. This result is different from that of Nóbrega, L.M., et al. [13]. They report the prevalence of facial trauma was lower among motorcycle accident victims than in motor vehicle accidents (p = 0.001). ...
... These trends are likely owing to improvements in vehicle and road safety [14] and similar findings have been demonstrated in ocular injury incidence across Western Europe and in other high-income regions [1,26]. A reduction in RTCrelated injuries may also account for the decline in patients with concomitant facial and pelvic injuries in our cohort as these are commonly associated with this injury mechanism [27]. Ocular injuries secondary to low falls in this setting increased significantly over the 18-year period from 7.2% to 25.2% and similar trends have been reported in other studies [1,[28][29][30][31]. ...
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Background Ocular trauma is a significant cause of blindness and is often missed in polytrauma. No contemporary studies report eye injuries in the setting of severe trauma in the UK. We investigated ocular injury epidemiology and trends among patients suffering major trauma in England and Wales from 2004 to 2021. Methods We conducted a retrospective study utilising the Trauma Audit and Research Network (TARN) registry. Major trauma cases with concomitant eye injuries were included. Major trauma was defined as Injury Severity Score >15. Ocular injuries included globe, cranial nerve II, III, IV, and VI, and tear duct injuries. Orbital fractures and adnexal and lid injuries were not included. Demographics, injury profiles, and outcomes were extracted. We report descriptive statistics and 3-yearly trends. Results Of 287 267 major trauma cases, 2368 (0.82%) had ocular injuries: prevalence decreased from 1.87% to 0.66% over the 2004–2021 period ( P < 0.0001). Males comprised 72.2% of ocular injury cases, median age was 34.5 years. The proportion of ocular injuries from road traffic collisions fell from 43.1% to 25.3% while fall-related injuries increased and predominated (37.6% in 2019/21). Concomitant head injury occurred in 86.6%. The most common site of ocular injury was the conjunctiva (29.3%). Compared to previous TARN data (1989–2004), retinal injuries were threefold more prevalent (5.9% vs 18.5%), while corneal injuries were less (31.0% vs 6.6%). Conclusions Whilst identifying eye injuries in major trauma is challenging, it appears ocular injury epidemiology in this setting has shifted, though overall prevalence is low. These findings may inform prevention strategies, guideline development and resource allocation.
... The maxillofacial region is one of the most complex regions in the human body [5]. Imaging this region becomes even more difficult in traumatized patients because of their clinical condition and inability to cooperate [6][7][8]. There is a discrepancy in the global incidence of facial fractures mainly due to the patient's age, socioeconomic status of the population investigated, geographical location, level of industrialization [9]. ...
Article
Background: Trauma to the maxillofacial region can lead to severe complications such as sinuses obstruction, intracranial injuries, and vision loss. Computed tomography has a critical rule for early evaluation of the maxillofacial region. This study aimed to evaluate the findings that occur due to maxillofacial injuries using computed tomography (CT). Material and Method: A total of 200 facial CT patients were retrospectively examined, extending from January 2019 to January 2020. 140 slice CT systems (Siemens Medical system) were applied to investigate patients with maxillofacial trauma at three hospitals in Taif, Saudi Arabia. Results: Out of the 200 maxillofacial traumas, Maxilla fractures were found in 71 patients (35%), and Nasal fractures were found in 56 patients (28%). Various maxillofacial fractures were seen, including Frontal, Zygomatic, Ethmoidal, Mandible, Temporal, and Parietal and Orbital bone. The adults ranged from 20 to 39 years were more commonly affected; maxillofacial fractures were more prevalent in men. Conclusion: various maxillofacial fractures were identified during a facial CT scan, and approximately one-third were male. The maxilla bone was the most common site of the fracture, followed by the nasal bone. Therefore, CT is essential for the patient with maxillofacial trauma for early management to avoid any complications for the patient.
... The rates were 68% and 63% in Asia and Africa, respectively, compared with 20% and 8% in Europe and Australia, respectively. The rate in the two Brazilian centers (34%) was intermediate, likely attributable to 'an intensification of educational campaigns and monitoring regarding the use of individual protection equipment such as helmets and compliance with legislation that prohibits alcohol intake in combination with driving' [49]. ...
Article
Background/Aim : The World Oral Maxillofacial Trauma (WORMAT) project was performed to analyse the causes and characteristics of maxillofacial fractures managed in 14 maxillofacial surgery divisions over a 1-year period. Methods : The following data were collected: age, sex, cause and mechanism of maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score (FISS), associated injury, day of trauma, timing and type of treatment, and length of hospitalisation. Statistical analyses were performed using SPSS software. Results : Between 30 September 2019 and 4 October 2020, 2,387 patients (1,825 males and 562 females [ratio 3.2:1], 47.6% aged 20–39 years [mean age 37.2 years, median 33.0 years]) were hospitalised. The main cause of maxillofacial fracture was road traffic accidents (RTA), which were statistically associated with male adults as like as assault, sport, and work (p<0,05). Half of the fractures involved the middle third of the face, statistically associated with fall and assault (p<0.05). Trauma in multiple locations was significantly associated with longer hospital stay (p<0.05). The mean length of hospitalization was 3.9 days (95% Confidence Interval 3.7-4.2). Conclusions : This prospective, multicenter epidemiological study confirmed that young adult males were the ones most commonly affected by maxillofacial fracture. RTAs and assaults are statistically associated with the adult population, while falls are associated with females and older population.
... 37 In contrast, lower incidences of RTA-related fractures in developed countries are related to the strict application of safety policies, including the mandatory use of seatbelts, motorcycle helmets and child restraints. 6,21,39,40 The current study showed that most patients (82%) involved in car or motorcycle accidents did not wear protection. This is a relevant problem not only in African and Asian centres, where RTA represents the main cause of fracture, but also in the remaining centres, suggesting that further informative and educational measures for both parents and children should be implemented to encourage the use of road safety devices. ...
Article
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Background/Aims The growth of the global elderly population will lead to an increase in traumatic injuries in this group, including those affecting the maxillofacial area, with a heavier load on health systems. The aim of this multicentric prospective study was to understand and evaluate the incidences, causes and patterns of oral and maxillofacial injuries in patients aged over 60 years admitted to 14 maxillofacial surgical departments around the world. Methods The following data were collected: gender, cause and mechanism of maxillofacial fracture, alcohol and drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment and length of hospitalization. Statistical analyses were performed using non-parametric and association tests, as well as linear regression. Results Between 30 September 2019 and 4 October 2020, 348 out of 2387 patients (14.6%), 197 men and 151 women (ratio 1.3:1; mean age 72.7 years), were hospitalized. The main causes of the maxillofacial fractures were falls (66.4%), followed by road traffic accidents (21.5%) and assaults (5.2%). Of the 472 maxillofacial fractures, 69.7% were in the middle third of the face, 28% in the lower third and 2.3% in the upper third. Patients with middle third fractures were on average 4.2 years older than patients with lower third fractures (95% CI 1.2–7.2). Statistical analysis showed that women were more involved in fall-related trauma compared with males (p < .001). It was also shown that road traffic accidents cause more fractures in the lower third (p < .001) and in the middle third-lower third complex compared with upper third (p < .001). Conclusions Maxillofacial fractures in the elderly were more frequent in European and Australian centres and affected men slightly more than women. Falls were the leading cause of fractures, especially among women. The middle third of the face was most often affected, and conservative treatment was the most common choice for the management of such patients.
... 37 In contrast, lower incidences of RTA-related fractures in developed countries are related to the strict application of safety policies, including the mandatory use of seatbelts, motorcycle helmets and child restraints. 6,21,39,40 The current study showed that most patients (82%) involved in car or motorcycle accidents did not wear protection. This is a relevant problem not only in African and Asian centres, where RTA represents the main cause of fracture, but also in the remaining centres, suggesting that further informative and educational measures for both parents and children should be implemented to encourage the use of road safety devices. ...
Article
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Background/aims: Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1-year period. Methods: The following data were collected: age (preschool [0-6 years], school age [7-12 years], and adolescent [13-18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. Results: Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0-18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001). Conclusion: The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0-6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.
... Maxillofacial injuries are one of the serious health complications in the world, including 7.4% to 8.4% of all emergencies (1,2). Injuries of this highly neurovascular zone can lead to disability in specialized functions, substantial morbidity and even mortality. ...
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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 (48.11%, n=127); common associated injuries were related to head (81.44%, n=215) followed by thorax (58.33%, n=154). Age and gender (being male) increased the odds ratio of mortality. An increase in ISS decreased the odds ratio of mortality, but it was not significant. Conclusion: Most of maxillofacial trauma patients suffered from orbital injuries and there were a huge percentage of associated injuries. Gender (male), age and length of hospital stay were the significant variables of mortality in maxillofacial patients. The findings of the current study sheds light on further investigation to treat these patients and enforce road traffic legislation and public education to prevent these traumas.
... Similar finding was revealed through the studies conducted in Yirgalem hospital [18], western Nepal [21] and India [22]. Furthermore, this study revealed that fractures and soft tissue injuries were the most common types of injuries encountered, which is supported by previous studies [23]. ...
... The etiology of craniofacial fractures varies. Some authors believe that the most common cause of these fractures are transport accidents [31], while others mention violence [3,30,32]. The type and severity of the injury largely depends on the studied population [33]. ...
Article
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Maxillofacial fractures (MFF) belong to the major modern medicine and public health concerns. The recovery from MFF is associated with a number of social problems. The patient’s mood may be affected by the change in self-image and lack of satisfaction with life, in many cases leading to a deepening of mental health disorders, resulting in alcoholism, loss of job or conflicts in the area of family life. The aim of this study was to evaluate the quality of life of patients with MFF, with respect to demographic and medical variables. The mean age of the 227 patients was 36 years. The mandible was the most frequent MFF location (52.9%), followed by the zygomatic bone (30.8%) then the maxilla (16.3%). Bone fracture displacement occurred in 79.3% of patients. A comminuted fracture was found in 71% of patients. The quality of life of patients with MFF was significantly better in all analyzed domains 3 months after the end of hospitalization compared to the initial survey carried out shortly after implementation of the treatment. Among the demographic variables, older age had a statistically significant but weak positive association with the improvement of the quality of life of respondents in General health perception domain.
... M axillofacial traumatology is currently an extremely important health subject worldwide, the fractures of the viscerocranium being the most frequent pathology found in ambulatory health care. [1] The importance of this pathology derives from its major potential complications, such as life-threatening hemorrhage, acute respiratory failure or neurological lesions compatible or incompatible with life, and not least, local esthetic and functional disorders. [2] The complexity of the most often interdisciplinary treatment of midfacial traumas requires the use of considerable financial resources. ...
Article
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Introduction: Midfacial fractures are extremely important oral and maxillofacial problems because they take varied forms and are frequently accompanied by major long-term esthetic or functional complications. Their etiology and epidemiology vary significantly in the literature, and the main causes are varied by population. The aim of this study is to identify the main traumatic etiology of midfacial fractures, along with the main categories of affected patients in our geographical area, in order to establish the need for measures that can prevent fractures in the future. Materials and methods: We conducted a retrospective study over a 10-year period in 379 patients. Data were extracted from the patients' charts, and the following variables were taken into consideration: sex, age, environment of origin, education level, and traumatic etiology. Results: Midfacial fractures most frequently affected the 20-29 years age group (31.93%), male sex (n = 333, 87.86%, M:F = 7.23:1), patients from urban areas (n = 206, 54.35%), and patients without education (46.70%). The most frequent etiology was interpersonal violence (44.85%), followed by fall trauma (16.62%) and road traffic accidents (15.30%). Statistical correlations evidenced that urban environment favors midfacial fractures caused by interpersonal violence and road traffic accidents or sports injuries, while in rural areas, domestic accidents and animal attacks are predominant (P = 0.000). Conclusions: The overwhelming incidence of interpersonal violence in our population is currently a major public health problem. Implementing laws and initiating national programs for the prevention of interpersonal violence would lead to a considerable reduction of midfacial fractures in the Western Romanian population.
... However, the common site of fracture is lower limbs followed by upper limbs and then skull bones [20]. The accidents are reported high at night and among automobile accidents [21]. ...
... Due to the high social and economic cost of road accidents and their physical and psychological effects on individuals and communities, today, traffic accidents is one of the most important topics of scientific research. Similarly, in Rafafsanjan MVAs (as the developing countries) are also social-economically very important (11,12). The purpose of this study was the identification and analysis of the characteristics of pre-hospital emergency MVA in Rafsanjan, Iran, during a period of one year (from 21 Mar 2013 to 20 Mar 2014). ...
... relation was noted between Days of admission into ICU and timing of accident, that is especially accidents happening in afternoon, evening and night. These results are almost in line with a recently published study which has reported higher rate of injuries at night with a prevalence ratio of 1.24 [24]. However, our results marginally differs from a study which has reported 24.44% at sunrise and 27.16% at sunset and severity was significantly greater at dawn and sundown than those happening during daylight (P<0.001) ...
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It was carried out to evaluate and assess types of injuries in road traffic accident and their severity reported to one of the tertiary care hospital through cross sectional systemic prospective and retrospective study. Present study was carried out among 302 road traffic accident cases of young adult age. Collection of data includes interviewing the patient and review of medical records. Non-fatal injuries with severity such as abbreviated injury score (AIS); Glasgow coma score (GCS); revised trauma score (RTS) were considered in this study. Study indicates that 74.83% of victims were male and there is a significant (p<0.01) association between AIS and male gender. Most of the accident injuries were mild in nature and 99% of victims were having abrasion in urethra. The mean severity of injuries as computed by AIS was 13.2±0.106, GCS was 14.25±0.085 and RTS was 7.89±0.234. 37.45% of accident injuries were in group from 18 to 24 years. There is a significant (p<0.05) correlation between days of admission into ICU as well as in timing of accident. We conclude that it is important for planning and execution authorities to design and develop strategies and plans to minimise injuries in chest wall and thoracic vasculature to avoid future complications in young adults.
... Road traffic accidents could also be classified as multiple traumas, increasing this category to 16.8% (Fig 1), but in this study they were classified according to medical chart records. These types of trauma are routinely seen at emergency care facilities here in Brazil [10,17,18]. ...
... To determine the most significant variables in urban systems (sociodemographic and transport-related factors) that are involved in the occurrence of road accidents, several researchers have used multivariate regression analyses, including [46][47][48][49][50][51][52][53][54][55][56]. ...
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Non-motorized transportation modes, especially cycling and walking, offer numerous benefits, including improvements in the livability of cities, healthy physical activity, efficient urban transportation systems, less traffic congestion, less noise pollution, clean air, less impact on climate change and decreases in the incidence of diseases related to vehicular emissions. Considering the substantial number of short-distance trips, the time consumed in traffic jams, the higher costs for parking vehicles and restrictions in central business districts, many commuters have found that non-motorized modes of transportation serve as viable and economical transport alternatives. Thus, local governments should encourage and stimulate non-motorized modes of transportation. In return, governments must provide safe conditions for these forms of transportation, and motorized vehicle users must respect and coexist with pedestrians and cyclists, which are the most vulnerable users of the transportation system. Although current trends in sustainable transport aim to encourage and stimulate non-motorized modes of transportation that are socially more efficient than motorized transportation, few to no safety policies have been implemented regarding vulnerable road users (VRU), mainly in large urban centers. Due to the spatial nature of the data used in transport-related studies, geospatial technologies provide a powerful analytical method for studying VRU safety frameworks through the use of spatial analysis. In this article, spatial analysis is used to determine the locations of regions that are characterized by a concentration of traffic accidents black zones) involving VRU injuries and casualties) in Sao Paulo, Brazil developing country), and Rome, Italy developed country). The black zones are investigated to obtain spatial patterns that can cause multiple accidents. A method based on kernel density estimation KDE) is used to compare the two cities and show economic, social, cultural, demographic and geographic differences and/or similarities and how these factors are linked to the locations of VRU traffic accidents. Multivariate regression analyses ordinary least squares OLS) models and spatial regression models) are performed to investigate spatial correlations, to understand the dynamics of VRU road accidents in Sao Paulo and Rome and to detect factors variables) that contribute to the occurrences of these events, such as the presence of trip generator hubs TGH), the number of generated urban trips and demographic data. The adopted methodology presents satisfactory results for identifying and delimiting black spots and establishing a link between VRU traffic accident rates and TGH hospitals, universities and retail shopping centers) and demographic and transport-related data.
... At higher concentrations, it determines slow reaction times and sleepiness, a reduction in peripheral vision and poor performance n routine activities, thus making alcohol drinking before driving a serious danger. Therefore, in several countries the penalty for driving under the influence of alcohol has been increased, and drivers who operate motor vehicles with high blood alcohol levels are criminalized [14]. ...
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Objective: The aim of this article was to review and discuss papers that were published during the past 30 years regarding the distribution and characteristics of motor vehicle accidents-related facial injuries throughout the world. Methods: We systematically reviewed all papers that were published in English between January 1980 and December 2013 using MEDLINE and the MeSH term "facial fractures" together with the term "motor vehicle". Results: The percentage of motor vehicle accidents as an etiological factor in epidemiological studies about maxillofacial injuries ranged between 11% and 85%. On the whole, a progressively decreasing trend was observed, particularly in North America, Brazil, and Europe. Discussion: Motor vehicle accidents are still one of the most important etiological factors for maxillofacial injuries. A great difference in the incidence of this kind of fractures between developed countries and developing countries can be observed.
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Resumo Introdução Os acidentes de trânsito são um problema para o sistema de saúde e para a sociedade, evidenciado pelas altas taxas de óbito, internações e atendimento nos serviços de saúde em função das lesões graves e incapacidades, repercutindo na funcionalidade e qualidade de vida dos indivíduos. Objetivo Identificar medidas de desfecho nos estudos sobre vítimas não fatais de acidentes de trânsito, para cumprir a primeira das etapas no desenvolvimento de um core set da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) para vítimas não fatais de acidentes de trânsito. Métodos Trata-se de uma revisão sistemática cuja busca foi feita nas bases de dados PubMed/MEDLINE e SciELO, entre 2011 e 2022, utilizando termos em inglês. A estratégia de busca combinou termos sobre as consequências dos acidentes de trânsito em adultos. A seleção dos artigos deu-se por dois revisores independentes, aplicando os critérios de elegibilidade. Resultados Foram localizados 626 estudos nas bases de dados e incluídos, na revisão, 91 artigos. As consequências observadas nos estudos foram lesões, fraturas e traumas. Na extração das medidas de desfecho, 780 conceitos foram identificados, vinculados a um total de 124 categorias da CIF nos componentes: função do corpo (30 categorias); estrutura do corpo (72 categorias); atividade e participação (20 categorias); e fatores ambientais (duas categorias). Conclusão Esta revisão sistemática revelou que as principais consequências dos acidentes de trânsito para as vítimas não fatais estão nas estruturas do corpo relacionadas ao movimento e à mobilidade e estabilidade das articulações.
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Introduction Traffic accidents are a problem for the health system and society, evidenced by the high rates of deaths, hospitalizations and care in health services due to serious injuries and disabilities, affecting the functioning and quality of life of individuals. Objective To identify outcome measures in studies on victims of non-fatal traffic accidents, to fulfill the first step in the development of a Core Set of the International Classification of Functioning, Disability and Health (ICF) for victims of non-fatal traffic accidents. Methods A systematic review of published articles was carried out in the electronic databases PubMed/MEDLINE and SciELO, between 2011 and 2022, using terms in English. The search strategy combined terms about the consequences of traffic accidents in adults. The selection of articles was carried out by two independent reviewers, applying the eligibility criteria. Results A total of 626 studies were located in the databases, and 91 articles were included in the review. The consequences observed in the studies were injuries, fractures and trauma. When extracting outcome measures, 780 concepts were identified, linked to a total of 124 ICF categories, in the components: body function (30 categories); body structure (72 categories); activity and participation (20 categories); and environmental factors (two categories). Conclusion This systematic review revealed that the main consequences of non-fatal traffic accidents for victims are in the body structures related to the movement, mobility and stability of joints.
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Background Ocular trauma is a major cause of vision loss and injuries are often missed in multiply injured patients. Major trauma demographics in the UK have changed but no contemporary studies report ocular injuries in this cohort. We aimed to investigate ocular injury epidemiology and trends amongst major trauma patients in England and Wales from 2004–2021. Methods A retrospective analysis of prospectively collected Trauma Audit and Research Network (TARN) registry data was conducted. Major trauma was defined as injury severity score > 15, and ocular injuries were identified using AIS codes. Demographics, injury profiles, and outcomes were extracted. Descriptive statistics and 3-yearly trend data are reported. Results Of 287 267 major trauma cases, 2368 (0.8%) had ocular injuries, decreasing significantly from 1.87% (2004/06) to 0.66% (2019/21) (P < 0.0001). Males comprised 72.2% and median age was 34.5 years which increased (p < 0.0001). Road traffic collisions declined from 43.1–25.3% of ocular injury cases while falls increased and became the predominant mechanism (37.6% in 2019/21). Nonaccidental injuries increased from 15% (2004/06) to 26.5% (2016/18) (p < 0.0001). Concomitant head injury was present in 86.6% of cases. Ophthalmic procedures increased from 1.2% (2004/06) to 5% (2019/21) (p < 0.0001). Compared to previous TARN data, retinal injuries increased 3-fold to 18.6% and corneal injuries decreased from 31–6.6%. Conclusions Identifying sight-threatening injuries in polytrauma is challenging. Ocular injury epidemiology has changed significantly, though overall incidence is low. These findings may inform guideline development, resource allocation, and training priorities.
Article
Road traffic accidents (RTA) are the major cause of maxillofacial injuries (MFIs) in developing countries (Akama et al. 2007). Road traffic accidents were reported to be the 9th most common cause of death and morbidity in the world and are expected to rise to 3rd position by 2020 (Peden et al. 2002). Maxillofacial injuries remain a serious clinical problem because of the involvement of complex anatomic region. Facial fractures occur most commonly in males in the third decade of life (Motamedi et al. 2014). The goal of treatment in facial fractures is to achieve anatomic reduction and restore function while increasing patient comfort and making postoperative care easier (Lachner et al. 1991). The aim of the study was to evaluate the cases of Maxillofacial injuries with the existing literature on its different presentation and management. An observational study was done from the patients of RTA with Maxillofacial injuries in ENT department and trauma centre of Sir T General hospital and Government Medical College, Bhavnagar for a period of 2 year. A total of 315 patients were included. Males are more commonly affected than females. The main etiological factor for RTA was motorcycle accidents. The trend of MFIs especially due to MCAs was on the rise after the age of 20 year. Anatomically the lower 1/3 section of the face was the most affected. Mandibular fractures were most common isolated fracture in MFIs. Open reduction and internal fixation (ORIF) by plating and screw was the treatment of choice for displaced, comminuted and multiple fractures of face. Facial trauma remains a major source of injury in all parts of the world. Its management involves many disciplines in the hospital setting, but knowledge of occlusion, the masticatory apparatus and anatomy is important for the best outcomes. This study was an analysis of demographic variables and outcome of the management adopted in patients presented to our department.
Article
Background: Many studies have investigated the issue of facial injuries caused by car accidents, but only a few have addressed the technical and clinical aspects of such accidents and injuries in depth. The aim of this study was to identify risk factors and protective elements for facial injuries in car accidents. Methods: We analysed the technical and clinical data of patients with facial injuries caused by car accidents over a 16-year period (2000-2016) and investigated the following factors: sitting position, sex, age, accident time, use of a seatbelt, deployment of the front airbag, direction of impact, speed at the time of collision, and occurrence and location of facial injuries. Results: Of the 1291 patients involved in car accidents who were included in our study, 291 (22.5%) had suffered facial injuries. We found a significant association between occurrence of facial injuries and sex, speed at the time of collision, impact from the back, seatbelt usage, and deployment of the front airbag. In accidents occurring at speeds over 40 km/h, automobile security measures had no significant influence on the occurrence of facial injuries in drivers and front-seat passengers. In accidents occurring at speeds between 0 and 20 km/h, seatbelt usage (without airbag deployment) solely showed a significant protective influence against the occurrence of facial injuries (odd ratio [OR], 0.130; confidence interval [CI], 0.038-0.451). In contrast, patients who were in accidents at speeds between 21 and 40 km/h suffered significantly fewer facial injuries when wearing a seatbelt with the front airbag being deployed (OR, 0.245; CI, 0.091-0.665) or undeployed (OR, 0.216; CI, 0.084-0.561). Conclusion: Male sex and a high speed at the time of collision are significant risk factors for the occurrence of facial injuries. The security measurements evaluated in this study only exerted a protective influence at low speeds (below 40 km/h). This indicates a possible weakness of these security systems with regard to preventing facial injuries. Engineers could benefit from these findings and improve the efficiency of existing security measures and eventually help decrease the incidence of facial injuries.
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A descriptive and cross-sectional study of 9 932 patients who presented oral and facial emergencies, assisted in the Maxillofacial Surgery emergency room of "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, was carried out from January, 2006 to December, 2010, in order to characterize them from the clinical and therapeutical points of view. It was found a high incidence of affected patients with acute pathological processes that constituted emergencies in the Maxillofacial Surgery Service, although just 3.3 % of them were hospitalized. There was a prevalence of patients with soft parts trauma, acute septic inflammatory processes and painful processes of head and neck. Most of the surgical and orthopedic procedures were carried out in the emergency room above mentioned, which belong to the category of minor surgery and under ambulatory care
Article
Objectives: The purpose of this European multicenter prospective study was to obtain more precise information about the demographic characteristics and etiologic/epidemiologic patterns of motor vehicle accidents (MVA)-related maxillofacial fractures. Study design: Of the 3260 patients with maxillofacial fractures admitted within the study period, 326 traumas were caused by MVAs with a male/female ratio of 2.2:1. Results: The maximum incidence was found in Zagreb (Croatia) (18%) and the minimum in Bergen (Norway) (0%). The most frequent mechanisms were car accidents, with 177 cases, followed by motorcycle accidents. The most frequently observed fracture involved the mandible, with 199 fractures, followed by maxillo-zygomatic-orbital (MZO) fractures. Conclusions: In all the 3 groups (car, motorcycle, and pedestrian), mandibular and MZO fractures were the 2 most frequently observed fractures, with some variations. The importance of analyzing MVA-related facial injuries and their features and characteristics should be stressed.
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Objetivo Determinar el nivel de satisfacción de los pacientes postoperados de traumatismo facial en el Hospital Nacional Dos de Mayo (HNDM). Material y Método Estudio cuantitativo, cohorte longitudinal, analítica. La población estuvo constituida por 36 pacientes con diagnóstico de traumatismo facial que se sometieron a cirugía en el servicio de cabeza y cuello del HNDM durante el periodo julio de 2014-febrero de 2015. Se utilizó un cuestionario sobre satisfacción global cuya confiabilidad es r = 0,95, que evalúa cinco dimensiones: Limitación funcional, apariencia facial, apariencia sexual y corporal, autoconcepto negativo y apariencia social. Los puntajes promedio obtenidos en la escala de Likert fueron comparados con la prueba T de student pareada. Se consideró un valor p < 0,05 como estadísticamente significativo. Resultados La satisfacción global de los pacientes postcirugía fue alta en comparación con lo alcanzado en la precirugía (p = 0,01). En las dimensiones limitación funcional, apariencia facial, autoconcepto negativo y apariencia social el 100% alcanzó un nivel de satisfacción alto en la postcirugía. En la dimensión de apariencia sexual y corporal, el 100% tuvo en el periodo postcirugía un nivel de satisfacción medio, respecto al nivel bajo obtenido en la precirugía. Conclusión Los pacientes postoperados de traumatismo facial en el Hospital Nacional Dos de Mayo presentan un alto nivel de satisfacción a nivel funcional, de apariencia facial, en autoconcepto y de apariencia social.
Article
Objective: This study describes the facial fractures of patients at a reference center in oral and maxillofacial surgery of a Public University Hospital in the city of Rio de Janeiro, from January 2003 to December 2012. Methods: The data were collected from medical records and included the fractured bones, etiology, gender, and age of the patients. A total of 202 cases were identified, and 159 were included in the study (129 men and 30 women). Results: The mandible was the most commonly injured bone (90 cases, 73 men and 17 women) with a mean age of 33.7 years old (±15.2), and traffic accidents (75 cases) were shown to be the major cause. Conclusion: In the city of Rio de Janeiro, young men in their fourth decade of life are prone to trauma to their facial bones, especially the mandible, and they are most commonly caused by traffic accidents.
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Objective: Road traffic accident (RTA) and its related injuries contribute to a significant portion of the burden of diseases in Iran. This paper explores the association between driver-related factors and RTA in the country. Methods: This cross-sectional study was conducted in Iran and all data regarding RTAs from March 20, 2010 to June 10, 2010 were obtained from the Traffic Police Department. We included 538 588 RTA records, which were classified to control for the main confounders: accident type, final cause of accident, time of accident and driver-related factors. Driver-related factors included sex, educational level, license type, type of injury, duration between accident and getting the driving license and driver's error type. Results: A total of 538 588 drivers (91.83% male, sex ratio of almost 13:1) were involved in the RTAs. Among them 423 932 (78.71%) were uninjured; 224 818 (41.74%) had a diploma degree. Grade 2 driving license represented the highest proportion of all driving licenses (290 811, 54.00%). The greatest number of accidents took place at 12:00-13:59 (75 024, 13.93%). The proportion of drivers involved in RTAs decreased from 15.90% in the first year of getting a driving license to 3.13% after 10 years'of driving experience. Neglect of regulations was the commonest cause of traffic crashes (345 589, 64.17%). Non-observance of priority and inattention to the front were the most frequent final causes of death (138 175, 25.66% and 129 352, 24.02%, respectively). We found significant association between type of accident and sex, education, license type, time of accident, final cause of accident, driver's error as well as duration between accident and getting the driving license (all P less than 0.001). Conclusion: Our results will improve the traffic law enforcement measures, which will change inappropriate behavior of drivers and protect the least experienced road users.
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India has one of the highest road traffic accident rates in the world. To lessen this burden, information on the contributing factors is necessary. We studied a series of cases of non-fatal road traffic accidents in two tertiary care hospitals in Pimpri, Pune, India. A total of 212 non-fatal road traffic accidents admitted over a period of one year in these two hospitals constituted the study sample. The study variables were, the gender of the accident victims, mode of accident, days of week on which the accident took place, time of day when the injury was sustained, part of the body injured, nature of injury, and self-reported reasons for the accident. data were summarized using percentages. The Chi-square test for goodness of fit was applied, to see whether there was any association between the different weekdays or time of day and the accidents. MALE : female ratio was almost 5 : 1, which was statistically significant (Chi-Square for goodness of fit = 95.11, df = 1, P < 0.0001). The maximum accidents occurred on Sundays and Mondays and the least around midweek (Wednesday). This pattern was also statistically significant (Chi-square for goodness of fit = 30.09, df = 6, P < 0.001). Pedestrians were the most vulnerable group, followed by drivers and pillions of two wheelers. These categories of road users contributed to almost 80% of the cases of Road Traffic Injuries (RTIs). Accidents were more likely in the time zone of 8 pm to midnight, followed by 4 pm to 8 pm (Chi-square for goodness of fit = 89.58, df = 5, P < 0.0001). A majority of the patients sustained multiple injuries followed by injuries to the lower limbs. A majority reported impaired visibility and fatigue as the cause of accident. Almost half (46.22%) of the injured admitted to drinking alcohol on a regular basis. Wide pavements and safe zebra crossings should be provided for pedestrians, as the highest casualty in this study were pedestrians. More accidents occurred on Sundays and Mondays and in the late evenings. Extra supervision by traffic police may be considered on Sundays / Holidays and the day following. Roads should be well lit to improve visibility after sunset.
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Background: Maxillofacial-oral injuries is a serious health problem in China. The main aetiologic factors and types of maxillofacial-oral injuries differ according to different geographical areas and socio-economic statuses of populations in different countries or within the same country. Aim: The aim of this study was to analyze the types and external causes of maxillofacial-oral injuries among hospitalized patients in Xi'an, China, and thereafter to determine the status of maxillofacial-oral injuries in this region and to provide clinical clues for a future prevention of these injuries. Material and methods: Totally, 627 patients aged 3-64 years with maxillofacial-oral injuries, who were hospitalized in two public stomatological hospitals in Xi'an from 1 January 2008 to 31 December 2008, were included in this study. The types and external causes of injuries were analyzed in terms of age, gender and urban and rural location. Results: The results showed that jaw fractures (n = 406, 64.8%) and contusion/laceration injuries (n = 161, 25.7%) were the most frequent injuries. Injuries were 4.6 times more common in males than in females. Most maxillofacial-oral injuries occurred in those aged 18-59 years (71.1%), with a peak incidence in the 15- to 39-year-old group (31.4%). The proportion of patients from urban areas (45.5%) was lower than that from rural areas (54.4%). Regardless of gender, age and location, vehicle traffic accidents was the most common cause (n = 263, 41.9%), followed by falls (n = 109, 17.2%) and fighting-induced injuries (n = 87, 13.9%). Conclusions: Preventive strategies for maxillofacial-oral injuries due to traffic accidents should be emphasized and promoted in the first hand, especially for males, rural residents and those aged between 18 and 59 years.
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The aim of this research was to assess oral and maxillofacial trauma in urban and rural populations of the same region. The data collected included age, gender, year and month of trauma occurrence, origin (rural and urban), cause of injury, and the type of oral and maxillofacial trauma. Records from 1121 patients with 790 instances of oral and maxillofacial trauma were evaluated. Statistical analysis was performed with the Statistical Package for Social Sciences (SPSS) version 17.0 software and involved descriptive statistics and Pearson's chi-squared test. Male patients were more prone to maxillofacial trauma (n = 537; 68%), and the patients were mostly from urban areas (n = 534; 67.6%). The male-to-female ratio was found to be 2.12:1 (urban zone, 1.72:1; rural zone, 3.49:1). The average age was 25.7 years (SD = 14.1). A traffic accident was the most common cause of oral and maxillofacial trauma (27%). The jaw (18%) was the most commonly fractured bone in the facial skeleton, followed by the zygoma (12.9%). Avulsion (8.5%) was the most common dental trauma. A significant statistical relationship was found between place of origin and gender (p < 0.001). Accidents involving animals were more frequent in rural areas (P < 0.001). Zygomatic fractures (p < 0.001), contusion (p = 0.003), and abrasion (p = 0.051) were the most common injuries among individuals from rural areas. Nasal fracture (p = 0.011) was the most frequent type of trauma in individuals from urban areas. According to these data, it seems reasonable to assume that specific preventive public policy for urban and rural areas must respect the differences of each region.
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Road traffic injuries (RTIs) contribute to a significant proportion of the burden of disease in Kenya. They also have a significant impact on the social and economic well-being of individuals, their families, and society. However, though estimates quantifying the burden of RTIs in Kenya do exist, most of these studies date back to the early 2000s-more than one decade ago. This article aims to present the current status of road safety in Kenya. Using data from the police and vital registration systems in Kenya, we present the current epidemiology of RTIs in the nation. We also sought to assess the status of 3 well-known risk factors for RTIs-speeding and the use of helmets and reflective clothing. Data for this study were collected in 2 steps. The first step involved the collection of secondary data from the Kenya traffic police as well as the National Vital Registration System to assess the current trends of RTIs in Kenya. Following this, observational studies were conducted in the Thika and Naivasha districts in Kenya to assess the current status of speeding among all vehicles and the use of helmets and reflective clothing among motorcyclists. The overall RTI rate in Kenya was 59.96 per 100,000 population in 2009, with vehicle passengers being the most affected. Notably, injuries to motorcyclists increased at an annual rate of approximately 29 percent (95% confidence interval [CI]: 27-32; P < .001). The mean age of death due to road traffic crashes was 35 years. Fatalities due to RTIs increased at an annual rate of 7 percent (95% CI: 6-8; P < .001) for the period 2004 to 2009. Observational studies revealed that 69.45 percent of vehicles in Thika and 34.32 percent of vehicles in Naivasha were speeding. Helmets were used by less than one third of motorcycle drivers in both study districts, with prevalence rates ranging between 3 and 4 percent among passengers. This study highlights the significant burden of RTIs in Kenya. A renewed focus on addressing this burden is necessary. Focusing on increasing helmet and reflective clothing use and enforcement of speed limits has the potential to prevent a large number of road traffic crashes, injuries, and fatalities. However, it is difficult to demonstrate the magnitude of the injury problem to policymakers with minimal or inaccurate data, and this study illustrates the need for national continuous, systematic, and sustainable data collection efforts, echoing similar calls for action throughout the injury literature.
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Although the epidemiology of facial injuries has been studied in many populations, there is a paucity of information in the literature in this relation in the Middle East including Iran. The aim of this study was to assess the epidemiology and mode of treatment of facial injuries in western Iran. We examined all patients with a maxillofacial injury who presented to the outpatient department or who were hospitalized in the Besat Hospital of Hamedan City, Iran, between 20 December 2007 and 20 December 2009. Of 2,450 patients (77% male, 23% female) with a facial injury, 90% sustained soft tissue injuries and 37% had bone fractures. Motor vehicle accidents (MVAs) were the most common cause of injuries (35%). The most frequent bone fracture occurred in the nasal bone (63.4%). The incidence of associated injuries was 8.3% (mostly orthopedic). Rigid internal fixation was the main treatment of facial fractures. Malpositioned zygomas and functional and aesthetic problems after reconstruction of nasal-orbital-ethmoid injuries were the most common postoperative complications. Although in many countries the rate of facial injuries due to traffic accidents is decreasing, MVA is still the major cause of facial trauma in Iran. This may be due to the lack of enforcement of traffic laws by police and insufficient compliance of the population in obeying traffic rules. Rigid internal fixation was the most common mode of treatment of facial fractures, and in spite of the severity of facial injuries, the rate of postoperative complications was relatively low.
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A significant reduction in road traffic accidents has been observed since prevention measures were introduced by the French public authorities in 2002. The goals of this study are to describe the burden of road traffic accidents in a French Departement, and to identify changes if any between the periods 1997-2001 and 2002-2006 on the basis of the disability adjusted life years (DALY). Years of lost life (YLL) and years lived with disability (YLD) were calculated for two periods using the mortality and incidence data in the Rhone Departement Registry of Road Traffic Accident Casualties. YLD and YLL that are related to road traffic accidents are at their maximum value between 15 and 24 years of age. For men, intracranial fractures and intracranial injuries dominate, and for women it is spinal cord injuries that account for highest rates of YLD. A reduction in the rates of YLL and YLD has been observed for both genders and all age groups between 1997-2001 and 2002-2006. The reduction in DALY between the two periods is explained both by the reduction in the number of fatalities and injuries but also by an increase in the age at which they occur.
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Background Cross-sectional studies with binary outcomes analyzed by logistic regression are frequent in the epidemiological literature. However, the odds ratio can importantly overestimate the prevalence ratio, the measure of choice in these studies. Also, controlling for confounding is not equivalent for the two measures. In this paper we explore alternatives for modeling data of such studies with techniques that directly estimate the prevalence ratio. Methods We compared Cox regression with constant time at risk, Poisson regression and log-binomial regression against the standard Mantel-Haenszel estimators. Models with robust variance estimators in Cox and Poisson regressions and variance corrected by the scale parameter in Poisson regression were also evaluated. Results Three outcomes, from a cross-sectional study carried out in Pelotas, Brazil, with different levels of prevalence were explored: weight-for-age deficit (4%), asthma (31%) and mother in a paid job (52%). Unadjusted Cox/Poisson regression and Poisson regression with scale parameter adjusted by deviance performed worst in terms of interval estimates. Poisson regression with scale parameter adjusted by χ2 showed variable performance depending on the outcome prevalence. Cox/Poisson regression with robust variance, and log-binomial regression performed equally well when the model was correctly specified. Conclusions Cox or Poisson regression with robust variance and log-binomial regression provide correct estimates and are a better alternative for the analysis of cross-sectional studies with binary outcomes than logistic regression, since the prevalence ratio is more interpretable and easier to communicate to non-specialists than the odds ratio. However, precautions are needed to avoid estimation problems in specific situations.
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Maxillofacial injuries constitute a substantial proportion of cases of trauma. This descriptive analytical study assesses the cause, type, incidence, and demographic and treatment data of maxillofacial fractures. A retrospective study on maxillofacial traumas was carried out in the Department of Plastic and Reconstructive Surgery at Sişli Etfal Hospital (Istanbul, Turkey) between January 1, 2000 and December 31, 2005. The study included 216 patients with a mean age of 29.8 years. Sex and age distribution of patients, etiology of trauma, localization of the fractures, treatment modalities, time to treatment after the trauma, and postoperative complications were recorded. The male predilection was 75.5%. Road traffic accident was the most common causative factor (67.1%), followed by interpersonal violence (19.4%), falls (12.5%), and work- and sport-related accidents (0.9%). A total of 50% of the patients suffered isolated mandibular fractures, 23.6% had isolated midface fractures, and 26.3% had combined midface and mandibular fractures. Regarding distribution of mandibular fractures, the majority (26.8%) occurred in the parasymphysis, 14.8% in the angulus, and 11.1% each in the symphysis and corpus. Complications occurred in 6% of patients, and the most common was malocclusion followed by infection and nonunion. The causes and pattern of maxillofacial fractures reflect trauma patterns within the community and, as such, can provide a guide for the design of programs geared toward prevention and treatment.
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This paper discusses appropriate strategies for multivariate data analysis in epidemiological studies. In studies where determinants of disease are sought, it is suggested that the complex hierarchical inter-relationships between these determinants are best managed through the use of conceptual frameworks. Failure to take these aspects into consideration is common in the epidemiological literature and leads to underestimation of the effects of distal determinants. An example of this analytical approach, which is not based purely on statistical associations, is given for assessing determinants of mortality due to diarrhoea in children. Conceptual frameworks provide guidance for the use of multivariate techniques and aid the interpretation of their results in the light of social and biological knowledge.
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Cranio-maxillofacial trauma management requires pertinent documentation. Using a large computerized database, injury surveillance and research data describe the whole spectrum of injuries. The goal of this study was to assess the effect of the five main causes of accidents resulting in facial injury on the severity of cranio-maxillofacial trauma. During a period of 10 years (1991-2000) 9,543 patients were admitted to the Department of Oral and Maxillofacial Surgery, University Hospital of Innsbruck with cranio-maxillofacial trauma. Data of patients were prospectively recorded including cause of injury, age and gender, type of injury, injury mechanisms, location and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures and concomitant injuries. Statistical analyses performed included descriptive analysis, chi square test, Fisher's exact test, and Mann-Whitney's U test. This was followed by logistic regression analyses for the three injury types to determine the impact of the five main causes on the type of injury at different ages in facial trauma patients. Five major categories/mechanisms of injury existed: in 3,613 (38%) cases it was activity of daily life, in 2991 (31%) sports, 1170 (12%) violence, in 1,116 (12%) traffic accidents, in 504 (5%) work accidents and in 149 (2%) other causes. A total of 3,578 patients (37.5%) had 7,061 facial bone fractures, 4,763 patients (49.9%) suffered from 6,237 dentoalveolar, and 5,968 patients (62.5%) from 7,769 soft tissue injuries. Gender distribution showed an overall male-to-female ratio of 2.1 to 1 and the mean age was 25.8+/-19.9 years; but both varied greatly depending on the injury mechanism (facial bone fractures: 35.4+/-19.5 years, higher risk for males; soft tissue injuries: 28.7+/-20.5, no gender preference; dentoalveolar trauma: 18+/-15.6, elevated risk for females). For patients sustaining facial trauma, logistic regression analyses revealed increased risks for facial bone fractures (225%), soft tissue lesions (58%) in patients involved in traffic accidents, and dental trauma (49%) during activities of daily life and play accidents. When compared with other causes, the probability of suffering soft tissue injuries and dental trauma, but not facial bone fractures, is higher in sports-related accidents, 12 and 16%, respectively. This study differentiated between injury mechanisms in cranio-maxillofacial trauma. The specially trained surgeons treating cranio-maxillofacial trauma are the primary source of information for the public and legislators on implementing preventive measures for high-risk activities. In facial trauma, older persons are prone to bone fractures (increase of 4.4%/year of age) and soft tissue injuries (increase of 2%/year of age) while younger persons are more susceptible to dentoalveolar trauma (decrease of 4.5%/year of age).
Article
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To investigate the relationship between social and biological conditions experienced in very early life and dental caries in children aged 6 years. The design was a dental caries cross-sectional study nested in a birth cohort study started in Pelotas, Brazil, in 1993. The cross-sectional study was carried out in 1999. A random sample of 400 6-year-old children was selected from among 5249 live births in 1993. The World Health Organization (1997) criteria were used to diagnose dental caries. Results from the oral health study were linked to the data concerning perinatal and childhood health and illnesses and family social conditions collected at birth, 1, 3, 6 and 12 months, and in the sixth year of life. Dental caries was the outcome measured at two levels of severity (very low: dmft < or = 1; high: dmft > or = 4). Unconditional univariate and multiple logistic regression analysis were performed. Self-employed and employees/unemployed, fathers with <8 years of education at time child was born, child's height deficit for age at 12 months; child who did not attend day care centre in sixth year of life; brushing teeth less than once a day, and children with sweet consumption of at least once a day at 6 years were risk factors for high dental caries after controlling for possible confounders. Harmful social and biological risk factors accumulated in early life contributed to the development of a high level of dental caries in childhood.
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We sought to determine the etiology and pattern of motorcycle-related maxillofacial injuries among intracity road users in Nigeria. We conducted a prospective review of all patients presenting at the maxillofacial surgery units of the Obafemi Awolowo University Teaching Hospital Ile-Ife and Usmanu Dan Fodiyo University Teaching Hospital Sokoto with motorcycle-related injuries. One hundred seven patients were included in the study. A significant male preponderance was observed (P = .002). Overall, the peak age incidence was 20 to 29 years, whereas female patients had a peak age incidence of 10 to 19 years. Victims were mostly riders (50.5%) but none of them was a female. While 8.4% of accidents occurred on motorcycles with more than one pillion passenger, none of the victims reported using a crash helmet. Mechanism of accident was mostly head-on collision (39.2%). The injuries sustained were predominantly soft tissue injuries or in combination with bone injury. Bone and dental injuries were attributed mostly to falls. Facial bone injuries occurred mostly in the mandible (64 of 104). A symmetric distribution of injuries was observed in the upper, middle, and lower thirds of the face, but the middle third had the highest injury sites while the upper third had the least. Motorcycle-related maxillofacial injuries among Nigerians affect males predominantly. The injuries sustained have a symmetric distribution and were mostly soft tissue injuries in isolation or in combination with bony injuries. The middle third of the face is most vulnerable. Mandatory use of safety helmets and education of cyclists on the appropriate number of pillion passengers are imperative to minimize the morbidity and mortality associated with motorcycle accidents.
Article
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In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland) from January 2001 to December 2005. The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident). The traffic accidents were the cause of 19.93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22.21%), followed by tooth and alveolar process injuries (20.71%) and mandibular fractures (18.69%). All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM. Our results exhibit that road traffic accidents remain among the main reasons of maxillofacial injuries following the traumas resulting from assaults and interpersonal violence. This succession of etiologic factors is in accordance with the data from the most developed countries. The relatively high incidence of injuries resulting from traffic accidents indicates the necessity to reinforce legislation aimed to prevent road traffic crashes and thus to reduce maxillofacial injuries among children and adults.
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The objective of this article is to assess the total economic costs of road traffic crashes in Barcelona, a metropolitan city located in Southern Europe. A cost-of-illness study was conducted using a prevalence approximation, a societal and healthcare system perspective, and a 1-year time horizon. Results were measured in terms of Euros in 2003. Total costs of road traffic crashes in Barcelona in 2003 were euro367 million. Direct costs equalled euro329 million (89.8% of total costs), including property damage costs, insurance administration costs and hospital costs. Police, emergency costs and transportation costs had a minimum effect on total direct costs. Indirect costs were euro37 million, including lost productivity due to hospitalization and mortality. The results of the sensitivity analysis showed the upper limit of total economic cost of road traffic crashes in Barcelona to be euro782 million. This is the first study to estimate the costs of road traffic crashes for a city in a developed country. The importance of the problem calls for further interventions to reduce road traffic crashes.
Article
Airbags are restraining safety devices, but their activation may sometimes induce injuries during road accidents. Rapid deceleration due to an impact causes the ignition of a sodium azide cartridge, which releases nitrogen gas to inflate the nylon rubber bag. Numerous high-temperature gases, sodium hydroxide, carbon dioxide, and various other metallic oxides are also released producing a corrosive alkaline aerosol. Cutaneous and extracutaneous injuries due to airbag deployment may occur. Cutaneous injuries are frequent, and consist of irritant dermatitis, and chemical and thermal burns. Furthermore, numerous kinds of traumatic lesions (abrasions, friction burns, and lacerations) may be observed. Extracutaneous damage may involve the eyes, ears, cardiovascular system, nerves, joints, and bones. The nature of airbag lesions, their frequency, and management are reported. Even though the majority of airbag lesions are minor and do not require hospitalization, correct diagnosis and the choice of the most suitable treatment are necessary.
Conference Paper
Objective: the aim of this research was to assess oral and maxillofacial trauma in urban and rural populations of the same region. Method: the data collected included age, gender, year and month of trauma occurrence, origin (rural and urban), cause of injury, and the type of oral and maxillofacial trauma. Records from 1121 patients with 790 oral and maxillofacial traumas were evaluated. Statistical analysis was performed by the Statistical Package for Social Sciences (SPSS) version 17.0 software and involved descriptive statistics and Pearson’s chi-squared test. Result: male patients were more prone to maxillofacial trauma (n=537; 68%) and the patients were mostly from urban areas (n=534; 67.6%). The male to female ratio was found to be 2.12:1 (urban zone: 1.72:1 and rural zone: 3.49:1). The average age was 25.7 years (SD=14.1). A traffic accident was the most common cause of oral and maxillofacial trauma (27%). The jaw (18%) was the most commonly fractured bone in the facial skeleton followed by the zygoma (12.9%). Avulsion (8.5%) was the most common dental trauma. A significant statistical relationship was found between place of origin and gender (p<0.001). Accidents with animals were more frequent in rural areas (P<0.001). Zygoma fractures (p<0.001), contusion (p=0.003), and abrasion (p=0.051) were the most common injuries among individuals from rural areas. Nasal fracture (p=0.011) was the most frequent type of trauma in individuals from urban areas. Conclusion: according to this data, it seems reasonable to assume that specific preventative public policy for urban and rural areas must respect the differences of each region.
Article
Introduction: Brazil is among the countries with the highest prevalence of people injured by traffic accidents, showing that in 2008, levels reached 18.3 victims for 100,000 habitants were victims of traffic accidents. Materials and methods: This retrospective study involved data collected from treated patients' charts at seven different hospitals located in three different cities all in the state of São Paulo, Brazil. Information was obtained through a standardized form, which was designed to investigate the epidemiologic features of maxillofacial traumas, restricted to victims of car accidents. Results: Three hundred ninety-six patients were victims of car crashes with mean age 29.75 years. The age group 18-30 years showed an association with facial trauma in 96 patients, 41.56 % of whom reported using seat belt. Le Fort I, II and III (70 %) and mandible (63.11 %) were more associated with body traumas and seat belt use. The most common soft tissue lesion was laceration with 189 cases (42.3 %). The treatment way was assessed, 93 (23 %) were treated surgically and 303 (77 %) underwent conservative treatment. Discussion: Classically, it is known front seat belt use was positively correlated with back seat belt use, healthy diet, dental and general health, regular walking, adequate sleep and no smoking. Accidents involving cars occurred more frequently in age group 18-30 years, suffering more general traumas and representing the nonusers group that wore fewer seat belts, caused, perhaps, by bigger access of the youth to cars, driving in high speed and to an inefficient fiscalization of the traffic laws.
Article
The objective of this article is to estimate and validate a logistic model of alcohol-impaired driving using previously ignored alcohol consumption behaviors, other risky behaviors, and demographic characteristics as independent variables. The determinants of impaired driving are estimated using the US Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) surveys. Variables used in a logistic model to explain alcohol-impaired driving are not only standard sociodemographic variables and bingeing but also frequency of drinking and average quantity consumed, as well as other risky behaviors. We use interactions to understand how being female and being young affect impaired driving. Having estimated our model using the 1997 survey, we validated our model using the BRFSS data for 1999. Drinking 9 or more times in the past month doubled the odds of impaired driving. The greater average consumption of alcohol per session, the greater the odds of driving impaired, especially for persons in the highest quartile of alcohol consumed. Bingeing has the greatest effect on impaired driving. Seat belt use is the one risky behavior found to be related to such driving. Sociodemographic effects are consistent with earlier research. Being young (18-30) interacts with two of the alcohol consumption variables and being a woman interacts with always wearing a seat belt. Our model was robust in the validation analysis. All 3 dimensions of drinking behavior are important determinants of alcohol-impaired driving, including frequency and average quantity consumed. Including these factors in regressions improves the estimates of the effects of all variables.
Article
The aim of this study was to present a large series of motorcycle- and bicycle-related traumas to the face in an attempt to identify the injury pattern in motorcyclists and bicyclists. Data were collected from patients during a 10-year period (1999 through 2009), which included demographic data, diagnosis of facial fractures, use of protective devices, dentoalveolar trauma, and facial soft tissue injuries. There were 556 patients with bicycle accidents and 367 with motorcycle accidents. Men were involved in 79% (436) of bicycles accidents and 82% (299) of motorcycle accidents. Young male patients were more frequent in bicycle and motorcycle accidents. Two hundred fifty bicyclists showed 311 maxillofacial fractures. Two hundred twenty-one motorcyclists showed 338 maxillofacial fractures. Motorcycle accidents caused multiple fractures in more patients. Seventy-six percent of motorcyclists were using helmets at the time of the accidents, whereas 6% of cyclists were using helmets. Motorcyclists showed a larger number of lacerations, whereas bicyclists showed a larger number of abrasions. Avulsion was the most common dentoalveolar injury for these accident types. Hospital stays were 3.8 days for motorcyclists and 1.3 days for bicyclists. The high-impact collisions typically observed in motorcycle accidents is directly related to larger percentages of soft tissue lacerations and facial fractures. The low-impact trauma that is observed in bicycle accidents is more commonly associated with soft tissue abrasion, hematoma, and dentoalveolar fractures. This stresses the need for compulsory legislation for helmet use with face-guards for cyclists and motorcyclists. It is important to take measures to alert the public regarding the severity of injuries likely to occur in bicycle- and motorcycle-related accidents and ways to prevent them.
Article
The presence of oral diseases and disorders can produce an impact on the quality of life of preschool children and their parents, affecting their oral health and well-being. However, socioeconomic factors could confound this association, but it has not been yet tested at this age. To assess the impact of early childhood caries (ECC), traumatic dental injuries (TDI) and malocclusions on the oral health-related quality of life (OHRQoL) of children between 2 and 5 years of age adjusted by socioeconomic factors. Parents of 260 children answered the Early Childhood Oral Health Impact Scale (ECOHIS) (six domains) on their perception of the children's OHRQoL and socioeconomic conditions. Two calibrated dentists (κ>0.8) examined the severity of ECC according to dmft index, and children were categorized into: 0=caries free; 1-5=low severity; ≥6=high severity. TDI and malocclusions were examined according to Andreasen & Andreasen (1994) classification and for the presence or absence of three anterior malocclusion traits (AMT), respectively. OHRQoL was measured through ECOHIS domain and total scores, and poisson regression was used to associate the different factors with the outcome. In each domain and overall ECOHIS scores, the severity of ECC showed a negative impact on OHRQoL (P<0.001). TDI and AMT did not show a negative impact on OHRQoL nor in each domain (P>0.05). The increase in the child's age, higher household crowding, lower family income and mother working out of home were significantly associated with OHRQoL (P<0.05). The multivariate adjusted model showed that the high severity of ECC (RR=3.81; 95% CI=2.66, 5.46; P<0.001) was associated with greater negative impact on OHRQoL, while high family income was a protective factor for OHRQoL (RR=0.93; 95% CI=0.87, 0.99; P<0.001). The severity of ECC and a lower family income had a negative impact on the OHRQoL of preschool children and their parents.
Article
The objective of this paper was to study the epidemiological characteristics of orofacial damage resulting from road accidents among victims assessed in the Oporto delegation of the Legal Medicine Institute, in Portugal. It was also our goal to analyze in which way orofacial sequelae was reflected in the victims' complete social reintegration.
Article
Road traffic crashes (RTCs) are responsible for a substantial fraction of morbidity and mortality and are responsible for more years of life lost than most of human diseases. In this review, we have tried to delineate behavioral factors that collectively represent the principal cause of three out of five RTCs and contribute to the causation of most of the remaining. Although sharp distinctions are not always possible, a classification of behavioral factors is both necessary and feasible. Thus, behavioral factors can be distinguished as (i) those that reduce capability on a long-term basis (inexperience, aging, disease and disability, alcoholism, drug abuse), (ii) those that reduce capability on a short-term basis (drowsiness, fatigue, acute alcohol intoxication, short term drug effects, binge eating, acute psychological stress, temporary distraction), (iii) those that promote risk taking behavior with long-term impact (overestimation of capabilities, macho attitude, habitual speeding, habitual disregard of traffic regulations, indecent driving behavior, non-use of seat belt or helmet, inappropriate sitting while driving, accident proneness) and (iv) those that promote risk taking behavior with short-term impact (moderate ethanol intake, psychotropic drugs, motor vehicle crime, suicidal behavior, compulsive acts). The classification aims to assist in the conceptualization of the problem that may also contribute to behavior modification-based efforts.
Article
Real world motor vehicle collision research of injuries due to deployment of "first-generation" air bags has been conducted by Transport Canada since 1993. Fifty-three fatal crashes (36 frontal impacts; 17 side collisions) involving 48 drivers and 10 right front passengers were reviewed. In the Canadian data, air bag deployment in five of nine low severity frontal crashes (delta-V (deltaV) < 25 km/h or 15 mph) was linked to five deaths, four of whom were autopsied (four adults with craniocervical (basal skull and C2 fracture with brainstem avulsion; "closed head injury"--no autopsy) or chest trauma (aortic or pulmonary artery tears); one child with atlanto-occipital dislocation). An occupant who is close ("out-of-position") to the air bag at the time of deployment is at risk for injury. In 27 high severity frontal impacts, unusual (e.g., pulmonary "blast" hemorrhage in one autopsied case) or isolated potentially survivable injuries (e.g., clinically documented ruptured right atrium; probable flail chest observed during the autopsy on a decomposed body) localized to the head, neck or chest in three possibly out-of-position drivers pointed to the deployed air bag as a source of injury. In one of 17 side collisions an out-of-position driver sustained a radiographically confirmed C1-C2 dislocation in a minimally intruded vehicle.
Article
To investigate orbital fractures that occurred in frontal automobile crashes and to determine the effects of frontal airbags on injury incidence and severity. The National Automotive Sampling System database files from 1993 to 2000 were examined. Frontal crashes were selected that included drivers and front-seat passengers only and excluded ejected occupants and rollover crashes. Orbital fractures could be closed, open, displaced, or any combination of these and were identified by using the Abbreviated Injury Scale codes. The analysis included 12,429,580 front-seat occupants from 25,464 cases. Of all occupants who were exposed to an airbag deployment, 0.09% sustained an orbital fracture. In contrast, occupants who were not exposed to an airbag deployment were more than twice as likely to sustain an orbital fracture (0.22%). In addition to reduction in incidence, airbags were also shown to decrease the severity of orbital fractures that occupants sustained. Occupants exposed to airbag deployment mostly sustained closed, less severe fractures (61.9%), whereas occupants not exposed to airbag deployment sustained the majority as more severe, open, displaced, or comminuted fractures (61.3%). This article presents the most comprehensive study of orbital fractures in automobile crashes to date. It is shown that both the incidence and the overall severity of orbital fractures decreases considerably with exposure to airbag deployment. This is accomplished because the airbag minimizes occupant contact with the windshield and steering wheel, which are the two leading sources of orbital fractures for occupants not exposed to airbag deployment.
Article
A prospective study of 159 patients seen with maxillofacial fractures as a result of road traffic accidents in a Nigerian inner city was performed. The male to female ratio was 2.9:1 and the dominant age group was 21-30 years. Occupants of commercial vehicles were the ones mostly involved; involvement of rear seat occupants was high. Increased numbers of patients were seen on Saturdays and in the month of June. This study substantiates the fact that there is added risk of sustaining facial fractures during the rainy and leisure periods. Therefore, there is a need to stress the importance of common restraint devices and good road habits during these 'high risk' periods to reduce the incidence of maxillofacial fractures due to the road traffic accidents.
Article
Road traffic accidents are considered to be the second highest cause of mortality in Iran. A study was conducted to describe road-traffic-related mortality data in Iran in a given period. All Iranian mortality data on road traffic accidents between March 1999 and 2000 (one complete Iranian calendar year) were obtained. The main variables studied were deceased's gender, age, education level, status (i.e. driver, car occupant, etc.), cause and place of death. A total of 15?482 individuals died from road traffic accidents in Iran in the study period. A disproportionate number of deceased individuals were male (79%), mostly aged 40 years or less (65%), and who were pedestrians or car occupants (62%). Head injury was the most common cause of road-traffic-related mortality (66%) in males and females of all ages. Following road traffic accidents, 57% of deaths occurred pre-hospital. Head injury is the most common single cause of mortality attributable to road traffic accidents in Iran, and since most deaths occur pre-hospital, it seems many are preventable. To overcome this major public health problem, there is an urgent need to develop a comprehensive injury control policy and strategy in Iran.
Article
Airbags are restraining safety devices, but their activation may sometimes induce injuries during road accidents. Rapid deceleration due to an impact causes the ignition of a sodium azide cartridge, which releases nitrogen gas to inflate the nylon rubber bag. Numerous high-temperature gases, sodium hydroxide, carbon dioxide, and various other metallic oxides are also released producing a corrosive alkaline aerosol. Cutaneous and extracutaneous injuries due to airbag deployment may occur. Cutaneous injuries are frequent, and consist of irritant dermatitis, and chemical and thermal burns. Furthermore, numerous kinds of traumatic lesions (abrasions, friction burns, and lacerations) may be observed. Extracutaneous damage may involve the eyes, ears, cardiovascular system, nerves, joints, and bones. The nature of airbag lesions, their frequency, and management are reported. Even though the majority of airbag lesions are minor and do not require hospitalization, correct diagnosis and the choice of the most suitable treatment are necessary.
Article
Safety of the airbag supplemental restraint system (airbag) is a well-known concern. Although many lives are saved each year through airbag use, injuries continue to occur, especially to the head. Airbag safety research has focused primarily on severe injuries, while minor and moderate injuries have been largely ignored. In this study, 205,977 injury cases from the 1995 to 2001 National Automotive Sampling System (NASS)/ Crashworthiness Data System (CDS) were surveyed to determine the prevalence of AIS 1 and 2 facial and brain loss of consciousness (LOC) injuries and determine if these injuries are a concern. The query was focused on frontal impacts in vehicles equipped with airbags. Only occupants wearing appropriate seatbelts were included in this study so that the airbag would provide occupant protection under optimal conditions. Of the 205,977 injury cases studied, 2.4% met this criterion. From the data gathered, the trends seem to indicate an increase in these specific injuries, both in terms of the total number and the proportion to all injury cases. In 1995, AIS 1 and 2 head injuries accounted for 96.5% of all head injuries caused by airbags. By 2001, the percentage had risen 3.0% to 99.5%. Injuries occurring in vehicles equipped with first-generation versus second generation airbags were compared, and data seem to suggest that there is a higher rate of minor and moderate head injuries when occupants are in second-generation airbag-equipped vehicles, even when appropriate lap and shoulder belts are used. The short timeframe surveyed prevents drawing meaningful conclusions about statistical significance, but the graphical representations of the data in this study underscore an urgent need for further investigation based on current trends in order to understand the issue of minor and moderate head injury prevention in regard to airbags.
Article
To clarify the relations of the severity of oral and maxillofacial injuries from traffic accidents (TAs) to seating position and the use of restraint systems. Hospital records were reviewed for all patients who had sustained oral or maxillofacial injuries in TAs and then were admitted to the Department of Oral and Maxillofacial Surgery, Dokkyo University School of Medicine (Tochigi, Japan), from 1994 through 2003. A total of 201 patients, with a mean injury severity score (ISS) of 7.9 +/- 7.6, were included in this study. Although patients with any oral or maxillofacial injury with an Abbreviated Injury Scale (AIS) score of 2 or more had extremely low ISSs, hospitalization was relatively long. The ISS and AIS score of the head or neck were significantly higher in unrestrained drivers (12.4 +/- 11.2, 1.2 +/- 1.4, respectively) than in restrained drivers (6.5 +/- 4.6, 0.4 +/- 1.0, respectively). However, AIS scores of the face were similar in unrestrained drivers (1.9 +/- 0.7) and restrained drivers (1.7 +/- 0.5). Furthermore, the incidence of maxillofacial fractures did not differ between the 2 groups. Because wearing seat belts cannot prevent all oral and maxillofacial injuries in motor vehicle occupants, both physicians and engineers must pay greater attention to the mechanisms of oral and maxillofacial injuries in TAs.
Article
To analyze craniomaxillofacial injuries in selected hospitals in the United Arab Emirates (UAE). This is a retrospective study of craniomaxillofacial injuries treated in 3 major hospitals in the UAE. Patient files were retrieved, reviewed, and analyzed. The main analysis outcome measures were the patients' name, age, and gender and the injuries' time, site, type, treatment and outcome. A total of 288 patients sustained 475 craniomaxillofacial injuries; road traffic accidents caused the majority of injuries. The patients ranged in age from 2 to 82 years (mean, 27.3 years), and the male-to-female ratio was 7:1. The yearly distribution of fractures peaked during 2001, and the monthly distribution peaked in January. The greatest number (41%) of patients were UAE nationals. Most patients (70.5%) had mandibular fractures, and the most common site was the body. There were 139 patients (48.3%) with a total of 171 midface fractures (36%); the most common fracture site was the zygomatic complex (29.8%). The most common treatment for jaw fractures was plating plus intermaxillary fixation. Stable zygomatic complex fractures were closely reduced (elevated), and unstable ones were treated by internal fixation. About 25% of the cases had 1 or more postoperative complication. Craniomaxillofacial injuries in the UAE included in this study are somewhat similar to those reported in other countries. Differences from other countries are probably related to factors peculiar to the UAE, such as climate, social trends, and the cosmopolitan population.
Impacto of oral diseases on oral health-related quality of life of preschool children
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Lei 11.705/2008—tolerância zero aplicada ao Código de Trânsito Brasileiro.
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