A Conservative Method for Treating Severely Displaced Pediatric Mandibular Fractures: An Effective Alternative Technique

Abstract Pediatric mandibular fractures have been successfully managed in various ways. The use of a lingual splint is an option. This article presents a 4-year old boy who was treated by an alternative conservative method with a combination of an arch bar plus a lingual splint, circum-mandibular wiring and IMF for the reduction, stabilization and fixation of a severely displaced bilateral man‌dibular body fracture. This technique is a reliable, noninvasive procedure; it also limits the discomfort and morbidity associated with maxillomandibular fixation or open reduction and internal fixation in pediatric patient

Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study

Background: The epidemiology of facial injuries varies based on lifestyle, cultural background and socioeconomic status in different countries and geographic zones. This study evaluated the epidemiology of maxillofacial fractures and treatment plans in hospitalized patients in Northeast of Iran (2015-2016). Material and Methods: In this retrospective study, the medical records of 502 hospitalized patients were evaluated in the Department of Maxillofacial Surgery in Kamyab Hospital in Mashhad, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. Data were analyzed with Mann–Whitney test, chi-squared test and Fisher’s exact test, using SPSS 21. Results: The majority of patients were male (80.3%). Most subjects were in 20-30-year age range (43.2%). The fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the body of the mandible. There was a significant association between the type of treatment and age. In fact, the age range of 16-59 years underwent open reduction internal fixation (ORIF) more than other age ranges (P=0.001). Also, there was a significant association between gender and fractures (P=0.002). Conclusions: It was concluded that patient age and gender and trauma significantly affected the prevalence of maxillofacial traumas, fracture types and treatment plans. This information would be useful for making better health policy strategies. Key words:Epidemiology, treatment, facial injuries, maxillofacial fractures, trauma

Hyoid bone position in different facial skeletal patterns

Hyoid bone plays a significant role in physiological functions of craniofacial region and it?s position adapts to changes of the head. The purpose of this study was to determine the position of the hyoid bone among subjects with class I, class II and class III skeletal patterns and evaluate the gender differences. One hundred and ten lateral cephalograms (59 females and 51 males) from different skeletal patterns (class I, II and III) were selected. The skeletal patterns were determined according to ANB angle. Using MicroDicom software, different linear and angular measurements (6 variables) was carried out to determine the position of hyoid bone. Intraclass correlation coefficient was used to verify reliability. Descriptive statistics of the variables were calculated and analyzed using two-way ANOVA and Bonferroni statistical methods. The mean distance from the hyoid bone (H) to mandibular plane (MP), to palatal plane (PP), as well as to a third cervical vertebra (C3) was more in males than females (p=0.023, p<0.001, p<0.001 respectively). The mean H to PP distance was significantly more in skeletal class I compared to class III (P=0.01). The mean H to C3 distance was significantly more in skeletal class I compared to class II (P=0.008). The mean angle between H-MP and H-PP did not show any statistical difference among three skeletal classes (p=0.102, P=0.213) and among male and female groups (P=0.172, P=0.904). The hyoid bone is positioned more superior and posterior in females than males and its location differs among different skeletal classes. It is placed more posterior in skeletal class II patterns and more inferior and anterior in skeletal class I patterns

Using Absorbable Gelatin Sponge to Facilitate Sinus Membrane Elevation during Open Sinus Lift: Technical Notes and Case Series

Ridge atrophy accompanied by the pneumatization of maxillary sinus in the maxillary posterior region may lead to inadequate bone height, thereby precluding implant placement. Therefore, it may be mandatory to perform a sinus membrane elevation procedure and augmentation in the bone. The present study aimed to introduce a novel modification method for sinus floor elevation using a gelatin sponge (Gelatamp, COLTÈNE ROEKO, India) in order for better visualization, hemostasis, and conservative maxillary sinus membrane dissection with the low risk of complications. Implant placement was performed in a case series of 28 patients with hyperpneumatized sinus or a moderately resorbed posterior maxillary alveolus. According to the findings, implant placement caused no complications in the patients. Furthermore, none of the patients experienced infections, sinusitis or graft and implant failure clinically and radiographically at the three- and six-month follow-up. Therefore, it could be concluded that gelatamp-assisted sinus lift is a simple, safe, noninvasive, and innovative technique for sinus membrane elevation. In addition, it is predictable and efficient, especially in the cases where piezoelectric surgery armamentarium is not available

Prevalence of Stylohyoid Ligament Calcification on Panoramic Radiographs in an Iranian Population

Introduction: The aim of this study was to investigate the prevalence of stylohyoid ligament complex elongation in a group of Iranian patients using digital panoramic radiographs. Methods: Panoramic radiographs of 1211 patients (684 females and 527 males) referred to the dental school of Hamadan university of medical science were selected from 2011 to 2013. The stylohyoid ligament complexes were investigated. Results: This abnormality was seen in both sexes. A calcified complex was found in 632 (52.2 %) of the patients. Both-sided (right and left) type 1 calcified complex (according to O’Carroll classification) was observed in 207 patients, while types 2–4 were found in 204, 112, and 109 patients, respectively. Conclusion: The results suggest that stylohyoid ligament calcification complex is frequent in Iranian population and present in both sexes with equal distribution. In addition, calcifications were seen more often at age of 20-40 years, and the extent of calcification did not show a tendency to increase with age

Nasal Floor Membrane Lifting for Dental Implant Placement in an Atrophic Premaxilla.

Introduction: Augmentation of atrophic alveolar ridges is an important aspect of functional restoration in modern oral rehabilitation. Vertical bone resorption of the dentoalveolar ridges remains a serious challenge for successful dental implant placement. The premaxilla region is one of the most challenging areas for implant restoration. Nasal floor approximation in anterior maxilla in concomitant with atrophy made where sufficient amount of augmentation is not possible make nasal lifting as an alternative technique. Report of a case: In this report, we described a successful case of nasal floor lifting for dental implant placement in an atrophic premaxilla. Conclusion: It might be concluded that nasal floor membrane lifting may be a reliable technique for implant recipient site rehabilitation in severe vertically atrophied premaxilla. However, further clinical trials are needed to support its relevancy

Dentomaxillofacial Radiographic Changes in a Group of Iranian Patients with End Stage Renal Disease Undergoing Hemodialysis

Introduction: This study aims to evaluate the dentomaxillofacial radiographic changes in end stage renal disease (ESRD) patients who were on hemodialysis. Methods: Parathyroid hormone (PTH), calcium, phosphorus and alkaline phosphatase (ALP) measurements, as well as Panoramic and periapical radiographs were obtained from seventy four patients with a history of end stage renal disease (ESRD). Results: 74 patients examined with age range of 15 to 68 years, and a mean age of 41.4±14.6 years. The duration of dialysis ranged between 3 to 156 months with a mean duration of 40.4 months. Thinning or loss of lamina dura was observed in 16 patients (51.4%) and calcification of the pulp in 28 patients (40%). Changes in trabecular pattern was observed in 30 patients (40.6%), alterations in jaw bone density in 29 patients (39.2%) and bilateral calcification of stylohyoid ligaments in 13 patients (17.6%). We did not notice any non periapical origin radiolucent lesion. There was a significant relationship between bone trabecular pattern with P level, age and duration of dialysis. Changes in bone density showed significant relationship with frequency and hours of dialysis per week. Conclusion: No correlation was found between the radiographic changes and Ca level. Although changes in trabecular pattern and density were observed mostly in those who were on hemodialysis for a relatively long time, but we could not establish a definitive relation of radiographic manifestations in ESRD patients with the duration and frequency of dialysis