Background： The treatment of the condylar fractures is difficult. Factors that result in the fractures are complex. The objective of this morphometric study was to investigate the relationship between condylar fractu...Background： The treatment of the condylar fractures is difficult. Factors that result in the fractures are complex. The objective of this morphometric study was to investigate the relationship between condylar fracture patterns and condylar morphological characteristics. Methods： We conducted a retrospective analysis of 107 patients admitted to the West China Hospital of Stomatology for bilateral condylar fractures caused by parasymphyseal impact. The patients were divided into five groups according to the type of condylar fracture. Ten parameters were evaluated on three-dimensional （3D） reconstruction mandible models through the Mimics 16.0 （Materialize Leuven, Belgium） anthropometry toolkit. Each parameter of the 3D models was analyzed using multivariate analysis. Multinomial logistic regression analyses were used to examine the relationships between the five groups. Results： The results showed that the differences of condylar head width （M 1 ）, condylar neck width （M3）, the ratio of condylar head width to condylar anteroposterior diameter （M1/M2）, the ratio of condylar head width to condylar neck width （M1/M3）, the ratio of condylar height to ramus height （M8/M7）, and mandibular angle （M10） were statistically significant （p 〈 0.05）. Type A condylar head fractures were positively associated with M1 （compared to Type B： OR ：1.627, 95% CI： 1.123, 2.359; compared to Type C： OR = 1.705, 95% CI： 1.170, 2.484） and M1/M2 （compared to Type B： OR = 1.034, 95% CI： 0.879, 2.484）. Type B condylar head fractures were negatively associated with M l 0 （compared to Type C： OR = 0.909, 95% CI： 0.821, 1.007）. Condylar neck fractures were negatively associated with M3 （compared to condylar head： OR = 0.382, CI： 0.203, 0.720 ; compared to condylar base： OR = 0.436, 95% CI： 0.218, 0.874）, and positively associated with M 1/M3 （compared to condylar head： OR = 1.229, 95% CI： 1.063, 1.420 compared to condylar base： OR = 1.223, 95% CI： 1.034, 1.447）. Condylar base fractures were positively associated with M10 （OR = 1.095, 95% CI： 1.008, 1.189） and negatively associated with M8/M7 （OR = 0.855, 95% CI： 0.763, 0.959） as compared with condylar head fractures. Conclusions： Condylar fracture pattern is associated with the anatomical features of the condyles when a fracture occurs from parasymphyseal impact.展开更多
BACKGROUNDMandibular fractures constitute about 80.79% of maxillofacial injuries inAlexandria University, either as isolated mandibular fractures or as a part ofpanfacial fractures. The combination of symphyseal and p...BACKGROUNDMandibular fractures constitute about 80.79% of maxillofacial injuries inAlexandria University, either as isolated mandibular fractures or as a part ofpanfacial fractures. The combination of symphyseal and parasymphyseal fracturesrepresent 47.09% of the total mandibular fractures.AIMTo compare the effectiveness of lag screws vs double Y-shaped miniplates in thefixation of anterior mandibular fractures.METHODSThis study is a prospective randomized controlled clinical trial, performed onsixteen patients with anterior mandibular fractures. Patients were divided equallyinto two groups, each consisting of eight patients. Group 1: Underwent openreduction and internal fixation using two lag screws. Group 2: Underwent openreduction and internal fixation using double Y-shaped plates. The followingparameters were assessed: operating time in minutes, pain using a visual analogscale, edema, surgical wound healing for signs and symptoms of infection,occlusion status and stability, maximal mouth opening, and sensory nervefunction. Cone beam computed tomography was performed at 3 and 6 mo tomeasure bone density and assess the progression of fracture healing.RESULTSThe study included 13 males (81.3%) and 3 females (18.8%) aged 26 to 45 years(mean age was 35.69 ± 6.01 years). The cause of trauma was road traffic accidentsin 10 patients (62.5%), interpersonal violence in 3 patients (18.8%) and othercauses in 3 patients (18.8%). The fractures comprised 10 parasymphyseal fractures(62.5%) and 6 symphyseal fractures (37.5%). The values of all parameters were comparable in both groups with no statistically significant difference except forthe mean bone density at 3 mo postoperatively which was 946.38 ± 66.29 in group 1 and 830.36 ± 95.53 in group 2 (P = 0.015).CONCLUSIONBoth lag screws and double Y-shaped miniplates provide favorable means offixation for mandibular fractures in the anterior region. Fractures fixed with lagscrews show greater mean bone density at 3 mo post-operation, indicative ofhigher primary stability and faster early bone healing. Further studies with largersample sizes are required to verify these conclusions.展开更多
文摘Background： The treatment of the condylar fractures is difficult. Factors that result in the fractures are complex. The objective of this morphometric study was to investigate the relationship between condylar fracture patterns and condylar morphological characteristics. Methods： We conducted a retrospective analysis of 107 patients admitted to the West China Hospital of Stomatology for bilateral condylar fractures caused by parasymphyseal impact. The patients were divided into five groups according to the type of condylar fracture. Ten parameters were evaluated on three-dimensional （3D） reconstruction mandible models through the Mimics 16.0 （Materialize Leuven, Belgium） anthropometry toolkit. Each parameter of the 3D models was analyzed using multivariate analysis. Multinomial logistic regression analyses were used to examine the relationships between the five groups. Results： The results showed that the differences of condylar head width （M 1 ）, condylar neck width （M3）, the ratio of condylar head width to condylar anteroposterior diameter （M1/M2）, the ratio of condylar head width to condylar neck width （M1/M3）, the ratio of condylar height to ramus height （M8/M7）, and mandibular angle （M10） were statistically significant （p 〈 0.05）. Type A condylar head fractures were positively associated with M1 （compared to Type B： OR ：1.627, 95% CI： 1.123, 2.359; compared to Type C： OR = 1.705, 95% CI： 1.170, 2.484） and M1/M2 （compared to Type B： OR = 1.034, 95% CI： 0.879, 2.484）. Type B condylar head fractures were negatively associated with M l 0 （compared to Type C： OR = 0.909, 95% CI： 0.821, 1.007）. Condylar neck fractures were negatively associated with M3 （compared to condylar head： OR = 0.382, CI： 0.203, 0.720 ; compared to condylar base： OR = 0.436, 95% CI： 0.218, 0.874）, and positively associated with M 1/M3 （compared to condylar head： OR = 1.229, 95% CI： 1.063, 1.420 compared to condylar base： OR = 1.223, 95% CI： 1.034, 1.447）. Condylar base fractures were positively associated with M10 （OR = 1.095, 95% CI： 1.008, 1.189） and negatively associated with M8/M7 （OR = 0.855, 95% CI： 0.763, 0.959） as compared with condylar head fractures. Conclusions： Condylar fracture pattern is associated with the anatomical features of the condyles when a fracture occurs from parasymphyseal impact.
文摘BACKGROUNDMandibular fractures constitute about 80.79% of maxillofacial injuries inAlexandria University, either as isolated mandibular fractures or as a part ofpanfacial fractures. The combination of symphyseal and parasymphyseal fracturesrepresent 47.09% of the total mandibular fractures.AIMTo compare the effectiveness of lag screws vs double Y-shaped miniplates in thefixation of anterior mandibular fractures.METHODSThis study is a prospective randomized controlled clinical trial, performed onsixteen patients with anterior mandibular fractures. Patients were divided equallyinto two groups, each consisting of eight patients. Group 1: Underwent openreduction and internal fixation using two lag screws. Group 2: Underwent openreduction and internal fixation using double Y-shaped plates. The followingparameters were assessed: operating time in minutes, pain using a visual analogscale, edema, surgical wound healing for signs and symptoms of infection,occlusion status and stability, maximal mouth opening, and sensory nervefunction. Cone beam computed tomography was performed at 3 and 6 mo tomeasure bone density and assess the progression of fracture healing.RESULTSThe study included 13 males (81.3%) and 3 females (18.8%) aged 26 to 45 years(mean age was 35.69 ± 6.01 years). The cause of trauma was road traffic accidentsin 10 patients (62.5%), interpersonal violence in 3 patients (18.8%) and othercauses in 3 patients (18.8%). The fractures comprised 10 parasymphyseal fractures(62.5%) and 6 symphyseal fractures (37.5%). The values of all parameters were comparable in both groups with no statistically significant difference except forthe mean bone density at 3 mo postoperatively which was 946.38 ± 66.29 in group 1 and 830.36 ± 95.53 in group 2 (P = 0.015).CONCLUSIONBoth lag screws and double Y-shaped miniplates provide favorable means offixation for mandibular fractures in the anterior region. Fractures fixed with lagscrews show greater mean bone density at 3 mo post-operation, indicative ofhigher primary stability and faster early bone healing. Further studies with largersample sizes are required to verify these conclusions.
