The Pattern of Oral and Maxillofacial Injuries Among Patients Attending Muhimbili National Hospital, Dar es salaam, Tanzania

To determine the pattern of oral and maxillofacial injuries among patients attended at the Muhimbili National Hospital, Dar es Salaam, Tanzania. Descriptive cross-sectional hospital based study. The study was done at oral and maxillofacial surgery firm and emergency medicine department of Muhimbili National Hospital (MNH). All patients who attended the Oral and Maxillofacial Surgery firm and Emergency Medicine departments of MNH for treatment of oral and maxillofacial injuries during the period of the study and consented were included in the study. An interview of the patients with oral and maxillofacial injuries was done through structured questionnaire to obtain relevant information from the patient. Social-demographic information (age, sex, address, education level and marital status), patient’s main complaint, type of injury, place where injury took place, cause of injury, general condition of patient immediately after injury and afterwards and the time interval from injury to reporting to hospital were recorded. Clinical findings were recorded as follows: type of injury, site of injury, single or multiple, soft tissue or hard tissue injury. Soft tissue injuries were categorized as bruises, abrasions, cut wound, contusion, lacerations, avulsions, and burn. Hard tissue injury was categorized as fracture of facial bones such as nasal bone, maxilla, mandible, zygoma, frontal palatal and orbital bones. Accompanying injuries to the TMJ were also recorded. Radiological investigations including plain skull radiography (posterior anterior view, Water’s view, submental vertex view), orthopantomograph and where necessary a computed tomography (CT) were ordered. The interpretation of the radiological investigations was done by the principal investigator with the assistance of an experienced clinician and was recorded in a special form as fracture or no fracture, site and type of fracture. Treatment offered and treatment outcomes were also recorded. For admitted patients the number of days spent in hospital was recorded against the type of injury and treatment done. The data was entered into computer and analysis was done using Statistical Package for Social Sciences programme (SPSS) Version 15. Association of maxillofacial injury parameters vii (demographic factors, aetiology, treatment and complications) and type of injuries was evaluated using Chi –square test (X2). Significant level p<0.05 was used to draw out conclusion. A total of 137 patients, 123 (89.8%) males and 14 (10.2%) females with the male- female ratio of 9:1 were included in this study. The age range was from 4 to 70 years with a mean age of 30.13 years. The 21-30 and 31-40 years age groups were the most affected. Road traffic accidents (RTA) were the most (64.2%) common causes of oral and maxillofacial injuries. The most common soft tissue injury was laceration in 63 (26.9%) patients followed by bruises in 57 (24.4%) and cut wounds in 54 (23.1%). Ninety-three patients (67.9%) had sustained fractures of either the mandible, mid face or both and of those 93 patients who sustained fracture, most had mandibular fractures 42 (45.2%). All patients received basic resuscitation procedures, for stabilization of the patient. Almost all (97.8%) patients with oral and maxillofacial injuries were given analgesics for pain control and prophylaxis antibiotics (96.4%). Surgical wound debridement and wound suturing were the most (62.8% and 53.3% respectively) common treatment for soft tissue injuries, while intermaxillary or mandibulomaxillary fixation was the most (51%) common hard tissue injuries treatment. A total of 27 (19.7%) patients suffered some complications after treatment. Infection was the most (59.3%) common complication followed by malunion (33.3%). This study showed that road traffic accidents were the most common cause of maxillofacial injuries. Assaults/interpersonal violence were the second most common cause of maxillofacial trauma. These findings should alert the authorities, particularly the government and the road safety commission to the need for improvement of our roads, enforcement of existing traffic laws, and improvement of socio-economic conditions of the general population

Evaluation of Records of Oral and Maxillofacial Surgery Cases Reported at Abbasi Shaheed Hospital and Karachi Medical and Dental College, Pakistan

Background: Oral and Maxillofacial Surgery department is a diverse field in dentistry. Record maintenance has been established as one of the key factors in the success and integrity of health care institutes.Objective: The objective of the study was to evaluate the records of oral and maxillofacial surgery casesreported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD ofKarachi Medical and Dental College.Methods: Cross sectional study was conducted in at ASH and KMDC from July 2019 to September 2019.The data from January 2017 to July 2019 was retrospectively noted through electronic surgical recordof ASH and records of the Oral Surgery OPD of KMDC. Inclusion criteria was patients records of bothgenders of 5–70 years age, having complaint of any oral or dental pathology or pathologies, trauma andimpactions. Data was calculated manually by calculating frequencies and percentages for the trauma,impaction and pathology cases of patients.Results: In 2017, 239 cases were treated under general anesthesia from which trauma 11. 45% (n=11),followed by 48. 11% (n=115) cases of oral pathologies, total 11.7% (n=28) cases of complicated exodontias. In2018, among 211, 51.1% (n=108) cases were trauma followed by 39.3% (n=83) cases of oral pathologies,whereas, total 9.4% (n=20) complicated exodontias cases were observed. During 2019 (January to July),168 cases 36.2% (n=62) cases were diagnosed as trauma, in oral pathology, overall 36.2% (n=62) caseswere surgically excised. Total 23.2% (n=39) complicated exodontias. In 2017, 25122 cases were reported in Surgery OPD of Karachi Medical and Dental College. Total 36.2% (n=9097) teeth were extracted from which 1.93% (n=486) cases were surgical impaction. On the other hand, 1.65% (n=416) patients were treated through minor oral surgeries. In 2018, 29008 cases were reported in Surgery OPD. Total 42.7% (n=12377) teeth were extracted from which 0.92% (n=268) cases were surgical impaction. On the other hand, 0.71% (n=208) patients were treated through minor surgeries. In 2019, January till July 13028 cases were reported in Surgery OPD. Total42.6% (n=5559) teeth were extracted from which 0.66% (n=87) cases were surgical impaction. On the other hand, 0.68% (n=89) patients were treated through minor surgeries.Conclusion: It has been concluded that evaluation of the records of oral and maxillofacial surgery casesreported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD ofKarachi Medical and Dental College were high and appropriate measures should be taken in order tomanage these problems timely and effectively

Maxillofacial prostheses challenges in resource constrained regions

Background: This study reviewed the current state of maxillofacial rehabilitation in resource-limited nations. Method: A rigorous literature review was undertaken using several technical and clinical databases using a variety of key words pertinent to maxillofacial prosthetic rehabilitation and resource-limited areas. In addition, interviews were conducted with researchers, clinicians and prosthetists that had direct experience of volunteering or working in resource-limited countries. Results: Results from the review and interviews suggest rehabilitating patients in resource-limited countries remains challenging and efforts to improve the situation requires a multifactorial approach. Conclusion: In conclusion, public health awareness programmes to reduce the causation of injuries and bespoke maxillofacial prosthetics training programmes to suit these countries, as opposed to attempting to replicate Western training programmes. It is also possible that usage of locally sourced and cheaper materials and the use of low-cost technologies could greatly improve maxillofacial rehabilitation efforts in these localities

Demographic and socioeconomic inequalities in the risk of emergency hospital admission for violence: cross-sectional analysis of a national database in Wales

Objectives To investigate the risk of emergency hospital admissions for violence (EHAV) associated with demographic and socioeconomic factors in Wales between 2007/2008 and 2013/2014, and to describe the site of injury causing admission. Design Database analysis of 7 years’ hospital admissions using the Patient Episode Database for Wales (PEDW). Setting and participants Wales, UK, successive annual populations ∼2.8 million aged 0–74 years. Primary outcome The first emergency admission for violence in each year of the study, defined by the International Classification of Diseases V.10 (ICD-10) codes for assaults (X85-X99, Y00-Y09) in any coding position. Results A total of 11 033 admissions for assault. The majority of admissions resulted from head injuries. The overall crude admission rate declined over the study period, from 69.9 per 100 000 to 43.2 per 100 000, with the largest decrease in the most deprived quintile of deprivation. A generalised linear count model with a negative binomial log link, adjusted for year, age group, gender, deprivation quintile and settlement type, showed the relative risk was highest in age group 18–19 years (RR=6.75, 95% CI 5.88 to 7.75) compared with the reference category aged 10–14 years. The risk decreased with age after 25 years. Risk of admission was substantially higher in males (RR=4.55, 95% CI 4.31 to 4.81), for residents of the most deprived areas of Wales (RR=3.60, 95% CI 3.32 to 3.90) compared with the least deprived, and higher in cities (RR=1.37, 95% CI 1.27 to 1.49) and towns (RR=1.32, 95% CI 1.21 to 1.45) compared with villages. Conclusions Despite identifying a narrowing in the gap between prevalence of violence in richer and poorer communities, violence remains strongly associated with young men living in areas of socioeconomic deprivation. There is potential for a greater reduction, given that violence is mostly preventable. Recommendations for reducing inequalities in the risk of admission for violence are discussed

Maxillofacial injuries associated with intimate partner violence in women

<p>Abstract</p> <p>Background</p> <p>The facial region has been the most common site of injury following violent episodes. The purpose of this study was to determine the prevalence and pattern of maxillofacial injuries associated with intimate partner violence (IPV) in women treated at a single facility in Malaysia.</p> <p>Methods</p> <p>A retrospective review of 242 hospital records of female IPV victims who were seen at the One-Stop Crisis Centre (OSCC) in Hospital Raja Perempuan Zainab II, Kelantan over a two-year period (January 1, 2005 to December 31, 2006) was performed. A structured form was used for data collection. Information regarding the anatomical sites of injuries, types of injuries, and mechanisms of assault were obtained.</p> <p>Results</p> <p>Most victims were married (85.1%), were injured by the husband (83.5%), and had at least one previous IPV episode (85.5%). Injury to the maxillofacial region was the most common (50.4%), followed by injury to the limbs (47.9%). In 122 cases of maxillofacial injuries, the middle of the face was most frequently affected (60.6%), either alone or in combination with the upper or lower third of the face. Injury to soft tissues (contusions, abrasions and lacerations) was the most common (87.7%).</p> <p>Conclusions</p> <p>This study indicates there is a high prevalence of maxillofacial injuries associated with IPV among women treated at the OSCC in Kelantan, Malaysia.</p

The epidemiological analysis of maxillofacial fractures in Italy: The experience of a single tertiary center with 1720 patients

Maxillofacial fractures represent a serious public health problem. Their epidemiology is extremely variable, and its analysis is crucial to establish effective treatment and prevention of these injuries. However only two works have been published about maxillofacial fracture epidemiology in Italy

Occupational group, educational level, marital status and deleterious habits among individuals with maxillofacial fractures : retrospective study

To investigate the occupational profile, educational level, marital status and deleterious habits to the health of patients with maxillofacial fractures of a population of northeastern Brazil. A retrospective study of patients records admitted to the Division of Oral and Maxillofacial Surgery at the Walter Cantídio University Hospital (Fortaleza, Brazil) who sustained maxillofacial fractures was conducted in the period between 2006 and 2015. A total of 338 patients rendered 355 fractures. Males were the most affected (p<0.001), with prevalence in the third decade of life (p<0.001). There was a predominance of motorcycle accidents (p<0.001), home workers (p<0.001), low educational status (p = 0.032), and no cigarette use (p<0.001) or alcohol (p = 0.023). Fractures of the zygomatic-orbital complex were the most prevalent in the sample (p<0.001). The sociodemographic profile exerted a significant influence on the epidemiological profile of maxillofacial fractures in a Brazilian population during the study period

The involvement of nurses and midwives in screening and brief interventions for hazardous and harmful use of alcohol and other psychoactive substances

This report provides details of a review of the literature on the involvement of nurses and midwives in screening and brief interventions for hazardous and harmful use of alcohol and other psychoactive substances

Spectrum of diseases and pattern of referral at the Oral Diagnosis Clinic of a tertiary dental center

Objective: The purpose of this study was to determine the scope of oral diseases and referrals within the Dental Centre at the University of Port Harcourt Teaching Hospital (UPTH). Method: The clinic logbook of the Oral diagnosis clinic of the Dental centre, University of Port Harcourt Teaching Hospital was reviewed retrospectively over an 18-month period. Demographic and clinical data of all patients were retrieved and statistically analyzed using SPSS Version 17.0. Result: There were 2,249 patients comprising 945 (42%) males and 1,304 (58%) females. The age range was 1month to 95 years and mean age, 29.9 + 16.8 years. The mean age for male was 30.4 + 17.3years and for female, 29.5±16.4 years. Based on their age, patients were categorized into children, youth, middle age and elderly. Patronage was predominantly by the youth category (age 17- 40 years). The predominant pathology presented was complicated dental caries (41.1%). Traumatic injuries showed predilections for the male gender (87 males compared to 58 females). Most of the referrals were to the Oral and Maxillofacial Surgery Clinic (825 patients) and tooth extraction (741 adults, 147 paediatric extractions) was the major reason for referral. Conclusion: In spite of the worldwide epidemiological report of its reducing incidence, dental caries and its sequelae are still the major reasons for patronage of dental health services in our environment and dental extraction is the mostly consumed treatment modality

Facial Injury Severity Scale Score as a Predictor of Length of Stay for Maxillofacial Fracture at Sanglah General Hospital, Denpasar, Bali, Indonesia

INTRODUCTION: Maxillofacial fracture is the most common trauma that happened in the developing countries. One of the methods to evaluate the severity of maxillofacial fracture is by using the Facial Injury Severity Scale (FISS) score. Maxillofacial trauma causes multiple injuries, thus resulted in various periods of hospitalization. AIM: The aim of this study is to use the employment of the FISS score to predict a patient’s length of stay. METHODS: This research was a retrospective cohort and cross-sectional study on maxillofacial fracture patients whom treated in Sanglah General Hospital, Denpasar, Bali. As much as 89 subjects were included in this study and information about their age, gender, mechanism of injury, FISS score, treatments, and length of stay was collected. The data were statistically analyzed using bivariate, receiver operating characteristics (ROC), and linear regression analysis. RESULTS: A total of 89 subjects were included in this study. Among them, 50 subjects had a high FISS score, and 39 subjects had low FISS score. The average age was 28.9 ± 13.3 years with a mean length of stay 6.39 ± 4.29 days. Bivariate analysis showed that the patients with high FISS score have 5.3 times higher risk to get a longer length of stay compared to those with low FISS score (95% CI: 2.289–12.289; p = 0.001). The mean of length of stay in subjects with a high FISS score was significantly higher compared to subjects with a low FISS score (mean for subjects with high score: 8.46 ± 4.63; mean for subjects with low score: 3.74 ± 1.46; p = 0.001) with a correlation value r = 0.718 (p = 0.001). ROC analysis represented that FISS score ˂4 was categorized as mild. The linear regression analysis showed that the length of stay for maxillofacial fracture patients was able to be predicted by LOS = 1.476 + 1.032 × FISS score. CONCLUSION: The FISS score can predict the length of stay for patients with maxillofacial fracture