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Single Institute Audit of Maxillofacial Trauma Cases Before and During COVID-19 Pandemic. COVID-19 大流行之前和期间颌面部创伤病例的单一研究所审计。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2022-04-20 DOI: 10.1177/19433875211064514
Mithilesh Kadanthode, Zainab Chaudhary, Pankaj Sharma, Sujata Mohanty, Chayanika Sharma
<p><strong>Study design: </strong>In the year 2020, we saw the emergence of severe acute respiratory syndrome coronavirus 2 causing COVID-19 into a full blown pandemic. This resulted in constraints on healthcare resources, and the attention was shifted to reduce cross contamination and prevent spreader events. Maxillofacial trauma care was also affected similarly, and most of the cases were managed by closed reduction whenever possible. A retrospective study was conducted to document our experience in treating maxillofacial trauma cases before and after nationwide lockdown due to COVID-19 pandemic in India.</p><p><strong>Objective: </strong>The objective of the study was to compare the effect of pandemic in reported pattern of mandibular trauma and the result of closed reduction procedures in the management of single or multiple fractures in mandible during this time period.</p><p><strong>Methods: </strong>The study was conducted in the Department of Oral and Maxillofacial Surgery, Maulana Azad institute of Dental Sciences, Delhi, for a period of 20 months, that is, 10 months before and after nationwide lock down which was effective from 23rd March 2020 due to COVID-19 pandemic. The cases were grouped into Group A (those reporting from 1st June 2019 to 31st March 2020) and Group B (those reporting from 1st April 2020 to 31st January 2021). Primary objectives were assessed and compared according to etiology, gender, location of the mandibular fractures, and treatment provided. Quality of life (QoL) associated with the treatment outcome by closed reduction was assessed after 2 months as a secondary objective using General Oral Health Assessment Index (GOHAI) in Group B.</p><p><strong>Results: </strong>A total of 798 patients sought treatment for mandibular fractures and included 476 patients in Group A and 322 in Group B. The groups showed similar age and male: female ratio. Cases showed a steep fall during first wave of pandemic, and most of the cases occurred as result of RTA followed by fall and assault. The fractures due to fall and assault showed an obvious rise during the lockdown period. There were 718 (89.97%) patients having exclusive mandibular fractures and 80 (10.03%) patients having involvement of both mandible and maxilla. Single fractures of mandible constituted 110 (23.11%) and 58 (18.01%) in Group A and B, respectively. 324 patients (68.07%) and 226 patients (70.19%) had multiple fractures involving mandible in respective groups. Parasymphysis of mandible was most commonly involved (24.31%) followed closely by unilateral condyle (23.48%) then Angle and Ramus of mandible (20.71%) with coronoid being the least fractured. During the initial 6 months after lockdown, all the cases were treated successfully using closed reduction. GOHAI QoL assessment conducted in cases having exclusive mandibular fracture (210 Multiple, 48 Single) showed favorable results with significant (P < .05) difference between the single and multiple fractures.</
研究设计:2020 年,严重急性呼吸系统综合征冠状病毒 2 导致 COVID-19 全面流行。这导致医疗资源紧张,人们将注意力转移到减少交叉感染和防止传播事件上。颌面部创伤护理也同样受到影响,大多数病例都尽可能采用闭合复位法进行处理。我们进行了一项回顾性研究,记录了印度 COVID-19 大流行导致全国封锁前后我们治疗颌面外伤病例的经验:该研究的目的是比较大流行对下颌骨创伤报告模式的影响,以及在此期间处理下颌骨单发或多发骨折的闭合复位术的结果:研究在德里毛拉纳-阿扎德牙科学院口腔颌面外科进行,为期 20 个月,即 COVID-19 大流行导致全国封锁(2020 年 3 月 23 日起生效)前后各 10 个月。病例被分为 A 组(2019 年 6 月 1 日至 2020 年 3 月 31 日报告的病例)和 B 组(2020 年 4 月 1 日至 2021 年 1 月 31 日报告的病例)。根据病因、性别、下颌骨骨折位置和治疗方法对主要目标进行评估和比较。作为次要目标,B组在2个月后使用口腔健康综合评估指数(GOHAI)评估了与闭合复位治疗结果相关的生活质量(QoL):共有 798 名下颌骨骨折患者寻求治疗,其中 A 组 476 人,B 组 322 人。病例数在大流行病的第一波期间急剧下降,大多数病例是由于道路交通意外造成的,其次是坠落和袭击。在封锁期间,跌倒和袭击导致的骨折明显增加。718例(89.97%)患者仅有下颌骨骨折,80例(10.03%)患者下颌骨和上颌骨同时受累。A 组和 B 组分别有 110 例(23.11%)和 58 例(18.01%)下颌骨骨折。各组中分别有 324 名患者(68.07%)和 226 名患者(70.19%)下颌骨多处骨折。下颌骨副干骺端最常见(24.31%),紧随其后的是单侧髁状突(23.48%),然后是下颌骨角和横突(20.71%),冠状突骨折最少。在锁定后的最初 6 个月中,所有病例均采用闭合复位法成功治疗。对下颌骨完全骨折的病例(210例多发骨折,48例单发骨折)进行的GOHAI QoL评估结果显示,单发骨折和多发骨折的疗效显著(P < .05):经过一年半的时间,我们从第二波疫情中恢复过来,对 COVID-19 有了更深入的了解,并采用了更好的管理方案。研究表明,在大流行病情况下,IMF 仍是治疗大多数面部骨折的金标准。从 QoL 数据中可以明显看出,大多数患者都能充分履行其日常职能。随着我国准备迎接第三波大流行,除非另有说明,否则闭合复位术仍将是大多数颌面部创伤的常规处理方法。
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引用次数: 0
Systematic Mapping Review of Orthognathic Surgery (Protocol). 正颌外科手术的系统映射审查(协议)。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2022-03-18 DOI: 10.1177/19433875221078385
Josefina Bendersky, Macarena Uribe, Maximiliano Bravo, Juan Pablo Vargas, Julio Villanueva, Gerard Urrutia, Xavier Bonfill

Study design: This document details the planning phase of a systematic mapping review.

Objective: The objective of this mapping review is to identify, describe, and organize evidence currently available from systematic reviews and primary studies regarding different co-interventions and surgical modalities used in orthognathic surgery (OS) and their outcomes.

Methods: Systematic reviews (SRs), randomized controlled trials (RCTs), and observational studies that evaluate perioperative OS co-interventions and surgical modalities will be identified in an exhaustive search of MEDLINE, EMBASE, Epistemonikos, Lilacs, Web of Science, and CENTRAL. Grey literature will also be screened.

Results: Expected results include identification of all PICO questions available in the evidence regarding OS and generation of evidence bubble maps, involving a matrix of all identified co-interventions, surgical modalities, and outcomes presented in the studies. This will achieve identification of research gaps and prioritization of new research questions.

Conclusions: The significance of this review will result in a systematic identification and characterization of the available evidence, leading to a reduction in research waste and a guidance of future efforts in developing studies for unsolved questions.

研究设计:本文件详细介绍了系统性映射综述的规划阶段:本图谱综述旨在识别、描述和整理目前从系统综述和主要研究中获得的有关正颌外科手术(OS)中使用的不同联合干预和手术方式及其结果的证据:方法:通过对 MEDLINE、EMBASE、Epistemonikos、Lilacs、Web of Science 和 CENTRAL 进行详尽检索,确定系统综述 (SR)、随机对照试验 (RCT),以及评估 OS 围手术期联合干预和手术方式的观察性研究。还将筛选灰色文献:预期结果包括在有关 OS 的证据中确定所有 PICO 问题,并生成证据气泡图,包括所有已确定的共同干预、手术方式和研究结果的矩阵。这将有助于确定研究差距和新研究问题的优先次序:本综述的意义在于系统地识别和描述现有证据,从而减少研究浪费,并为今后针对未解决的问题开展研究提供指导。
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引用次数: 0
Comparison of Efficacy and Safety of Hybrid Arch Bar with Erich Arch Bar in the Management of Mandibular Fractures: A Randomized Clinical Trial. 混合弓形矫形器与 Erich 弓形矫形器在下颌骨骨折治疗中的有效性和安全性比较:随机临床试验。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2022-03-29 DOI: 10.1177/19433875221080019
Hariram Sankar, Sachin Rai, Satnam S Jolly, Vidya Rattan

Study design: A clinical randomized control trial.

Objective: To compare the efficacy and safety of Hybrid arch bar (HAB) with Erich arch bar (EAB) in fracture management of the mandible.

Methods: In this randomized clinical trial, 44 patients were divided into 2 groups:- Group 1, N = 23 (EAB group) and Group 2, N = 21 (HAB group). The primary outcome was time taken for the application of arch bar, while the inner and outer glove puncture, operator prick, oral hygiene, arch bar stability, complications of HAB, and cost comparison were secondary outcomes.

Results: The time taken for the application of arch bar in group 2 was significantly shorter than group 1 (55.66 ± 17.869 min vs 82.04 ± 12.197 min) and the frequency of outer glove puncture was also significantly lesser for group 2 (0 punctures vs 9 punctures). Better oral hygiene was found in group 2. EAB was cost-effective than HAB (Rs 700 ± 239.79 vs Rs 1742.50 ± 257.14). The stability of the arch bar was comparable in both groups. Group 2 had associated complications of root injury in 2 out of 252 screws placed and the screw head got covered by soft tissue in 137 out of 252 screws placed.

Conclusions: Thus, HAB was better than EAB with a shorter time of application, less risk of prick injury, and improved oral hygiene.Clinical trial registry name- clinical trials registry- India, URL-http://ctri.nic.in, registration number- CTRI/2020/06/025966.

研究设计临床随机对照试验:比较Hybrid弓形固定器(HAB)和Erich弓形固定器(EAB)在下颌骨骨折治疗中的有效性和安全性:在这项随机临床试验中,44 名患者被分为两组:第一组,23 人(EAB 组);第二组,21 人(HAB 组)。主要结果是应用牙弓杆所需时间,次要结果是内外手套穿刺、操作者刺伤、口腔卫生、牙弓杆稳定性、HAB并发症和成本比较:结果:第 2 组应用拱杆的时间明显短于第 1 组(55.66 ± 17.869 分钟 vs 82.04 ± 12.197 分钟),第 2 组外手套穿刺的频率也明显低于第 1 组(0 次 vs 9 次)。EAB 的成本效益高于 HAB(700±239.79 卢比 vs 1742.50±257.14 卢比)。两组的弓杆稳定性相当。第 2 组的 252 颗螺钉中有 2 颗造成了牙根损伤,252 颗螺钉中有 137 颗的螺钉头被软组织覆盖:因此,HAB比EAB更好,应用时间更短、刺伤风险更小、口腔卫生更好。临床试验登记处名称-临床试验登记处-印度,URL-http://ctri.nic.in,登记号-CTRI/2020/06/025966。
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引用次数: 0
Printing in Time for Cranio-Maxillo-Facial Trauma Surgery: Key Parameters to Factor in. 颅颌面创伤手术的及时打印:需要考虑的关键参数。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2022-04-20 DOI: 10.1177/19433875221083231
Léonard Bergeron, Michelle Bonapace-Potvin, François Bergeron

Study design: retrospective cohort study.

Objective: 3D printing is used extensively in cranio-maxillo-facial (CMF) surgery, but difficulties remain for surgeons to implement it in an acute trauma setting because critical information is often omitted from reports. Therefore, we developed an in-house printing pipeline for a variety of cranio-maxillo-facial fractures and characterized each step required to print a model in time for surgery.

Methods: All consecutive patients requiring in-house 3D printed models in a level 1 trauma center for acute trauma surgery between March and November 2019 were identified and analyzed.

Results: Sixteen patients requiring the printing of 25 in-house models were identified. Virtual Surgical Planning time ranged from 0h 08min to 4h 41min (mean = 1h 46min). The overall printing phase per model (pre-processing, printing, and post-processing) ranged from 2h 54min to 27h 24min (mean = 9h 19min). The overall success rate of prints was 84%. Filament cost was between $0.20 and $5.00 per model (mean = $1.56).

Conclusions: This study demonstrates that in-house 3D printing can be done reliably in a relatively short period of time, therefore allowing 3D printing usage for acute facial fracture treatment. When compared to outsourcing, in-house printing shortens the process by avoiding shipping delays and by having a better control over the printing process. For time-critical prints, other time-consuming steps need to be considered, such as virtual planning, pre-processing of 3D files, post-processing of prints, and print failure rate.

研究设计:回顾性队列研究.目的:3D打印技术在颅颌面(CMF)手术中得到了广泛应用,但外科医生在急性创伤环境中实施该技术仍存在困难,因为报告中经常遗漏关键信息。因此,我们为各种颅颌面骨折开发了内部打印流水线,并描述了及时打印出手术模型所需的每个步骤:确定并分析了2019年3月至11月期间在一级创伤中心进行急性创伤手术时需要内部3D打印模型的所有连续患者:结果:确定了需要打印 25 个内部模型的 16 名患者。虚拟手术规划时间从 0 小时 08 分钟到 4 小时 41 分钟不等(平均 = 1 小时 46 分钟)。每个模型的整体打印阶段(预处理、打印和后处理)从 2 小时 54 分钟到 27 小时 24 分钟不等(平均 = 9 小时 19 分钟)。整体打印成功率为 84%。每个模型的灯丝成本在 0.20 美元到 5.00 美元之间(平均 = 1.56 美元):本研究表明,内部三维打印可在相对较短的时间内可靠完成,因此可将三维打印用于急性面部骨折治疗。与外包相比,内部打印可避免运输延误,并能更好地控制打印过程,从而缩短流程。对于时间紧迫的打印,还需要考虑其他耗时的步骤,如虚拟规划、三维文件预处理、打印后处理和打印失败率。
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引用次数: 0
Extracorporealization of the Mandibular Condyle: Effects on Viability and Function. 下颌髁状突体外剥离术:对活力和功能的影响
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2022-05-02 DOI: 10.1177/19433875221095989
Max R Emmerling, Meghan LaVigne, Gary Warburton, John F Caccamese, Robert A Ord

Study design: For certain condylar fractures, extracorporealization of the condylar segment may be performed via extra-oral vertical ramus osteotomy (EVRO) to facilitate reduction and fixation. This approach can similarly be used for condyle-sparing resection of osteochondromas of the condyle. Due to controversy regarding long-term health of the condyle after extracorporealization, we conducted a retrospective analysis of surgical outcomes.

Objective: For certain condylar fractures, extracorporealization of the condylar segment may be performed via extra-oral vertical ramus osteotomy (EVRO) to facilitate reduction and fixation. This approach can similarly be used for condyle-sparing resection of osteochondromas of the condyle. Due to controversy regarding long-term health of the condyle after extracorporealization, we investigated the viability of this technique through a retrospective analysis of outcomes.

Methods: Twenty-six patients were treated using EVRO with extracorporealization of the condyle for both condylar fractures (18 patients) and osteochondroma (8 patients). Of the 18 trauma patients, 4 were excluded due to limited follow-up. Clinical outcomes were measured, including occlusion, maximum interincisal opening (MIO), facial asymmetry, incidence of infection, and temporomandibular joint (TMJ) pain. Radiographic signs of condylar resorption were investigated, quantified, and categorized using panoramic imaging.

Results: Average follow-up was 15.9 months. Average maximum interincisal opening was 36.8 mm. Four patients demonstrated mild resorption and one patient demonstrated moderate resorption. Two cases of malocclusion were attributed to failed repairs of other concurrent facial fractures. Three patients reported TMJ pain.

Conclusions: Extracorporealization of the condylar segment with EVRO to facilitate open treatment of condylar fractures is a viable treatment option when more conventional approaches prove unsuccessful.

研究设计:对于某些髁突骨折,可通过口外垂直嵴截骨术(EVRO)对髁突部分进行体外剥离,以促进骨折的复位和固定。这种方法同样可用于髁突骨软骨瘤的保髁切除术。由于体外碎骨术后髁突的长期健康状况存在争议,我们对手术结果进行了回顾性分析:对于某些髁状突骨折,可通过口外垂直嵴截骨术(EVRO)对髁状突部分进行体外剥离,以促进骨折的还原和固定。这种方法同样可用于髁突骨软骨瘤的保髁切除术。由于对体外碎骨术后髁突的长期健康状况存在争议,我们通过对结果的回顾性分析研究了这种技术的可行性:26名患者接受了髁突骨折(18名)和骨软骨瘤(8名)的体外剥离治疗。在 18 名外伤患者中,有 4 人因随访时间有限而被排除在外。对临床结果进行了测量,包括咬合、最大椎间隙(MIO)、面部不对称、感染发生率和颞下颌关节(TMJ)疼痛。使用全景成像技术对髁突吸收的影像学迹象进行调查、量化和分类:平均随访时间为 15.9 个月。平均最大颌间开度为 36.8 毫米。四名患者表现为轻度吸收,一名患者表现为中度吸收。两例咬合不正的原因是同时发生的其他面部骨折修复失败。三名患者报告颞下颌关节疼痛:结论:当传统方法无法成功治疗髁突骨折时,使用EVRO对髁突部分进行体外剥离以促进髁突骨折的开放性治疗是一种可行的治疗方法。
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引用次数: 0
Patterns and Trends of Facial Fractures at a Tertiary Care Trauma Center in India - A 13 years Retrospective Study. 印度一家三级医疗创伤中心面部骨折的模式和趋势--13 年回顾性研究。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2022-04-19 DOI: 10.1177/19433875221084172
Debraj Shome, Monika Surana, Shiva Ram Male, Vaibhav Kumar, Supriya S Vyavahare, Arundha Abrol, Rinky Kapoor

Study design: Retrospective study.

Objective: The purpose of this study was to retrospectively analyze the prevalence, pattern, diagnosis, and treatment of the facial fractures falling under ambit of facial plastic surgery in a multi-specialty hospital at India from the year 2006-2019.

Methods: This retrospective study analyzed 1508 patients, having orbital fractures (from 2006 to 2019) for demographic data, cause of trauma, type of fracture, and the treatment given. The data were compiled in excel and analyzed by using SPSS version 21.0.

Results: Out of these 1508 patient (1127 (74.73%)-males and 381 (25.27%)-females), the etiology of injuries was Road traffic accident (RTA) (49.20%), assault (26.52%), and sports injuries (11.47%). The most common fracture pattern was Isolated Orbit and/or Orbital Floor fracture in 451 patients (32.08%), followed by Mid-facial fractures (21.93%). Also, 105 patients (6.96%) experienced ocular/retinal trauma along with other fractures.

Conclusions: Orbit, peri-ocular, and mid-face trauma comprised a large position of this study. It requires a great deal of expertise to treat such complex trauma, which is not covered in one specialty alone. Hence, a holistic approach of craniofacial fracture management, rather than limiting these skills to water-tight craniofacial compartments becomes necessary. The study highlights the critical need of multidisciplinary approach for predictable and successful management of such complex cases.

研究设计回顾性研究:本研究旨在回顾性分析2006-2019年印度一家多专科医院面部整形外科范围内面部骨折的患病率、模式、诊断和治疗情况:这项回顾性研究分析了 1508 名眼眶骨折患者(2006 年至 2019 年)的人口统计学数据、外伤原因、骨折类型和治疗方法。数据以 excel 格式编制,并使用 SPSS 21.0 版进行分析:在这 1508 名患者中(男性 1127 人(74.73%),女性 381 人(25.27%)),受伤病因为道路交通事故(RTA)(49.20%)、袭击(26.52%)和运动损伤(11.47%)。最常见的骨折类型是孤立性眼眶和/或眶底骨折,共有 451 名患者(32.08%),其次是面中部骨折(21.93%)。此外,有 105 名患者(6.96%)在发生其他骨折的同时还伴有眼部/视网膜创伤:本研究中,眼眶、眼周和面中部创伤占很大比例。治疗这种复杂的外伤需要大量的专业知识,而这不是一个专业就能完成的。因此,有必要对颅面骨折进行整体处理,而不是将这些技能局限于颅面部位。该研究强调了多学科方法对于可预测和成功处理此类复杂病例的关键必要性。
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引用次数: 0
Treatment of Persistent Post-traumatic Diplopia - An Algorithmic Approach to Patient Stratification and Operative Management. 外伤后持续性复视的治疗--患者分层和手术治疗的算法方法。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2022-03-26 DOI: 10.1177/19433875221083084
Sashank K Reddy, Salih Colakoglu, Joshua S Yoon, Myan Bhoopalam, Shannath L Merbs, Paul N Manson, Michael P Grant

Study design: Retrospective chart review of revisional orbital surgery outcomes in patients with diplopia from prior operative treatment of orbital trauma.

Objective: Our study seeks to review our experience with management of persistent post-traumatic diplopia in patients with previous orbital reconstruction and present a novel patient stratification algorithm predictive of improved outcomes.

Methods: A retrospective chart review was performed on adult patients at Wilmer Eye Institute at Johns Hopkins Hospital and at the University of Maryland Medical Center who underwent revisional orbital surgery for correction of diplopia for the years 2005-2020. Restrictive strabismus was determined by Lancaster red-green testing coupled with computed tomography and/or forced duction. Globe position was assessed by computed tomography. Seventeen patients requiring operative intervention according to study criteria were identified.

Results: Globe malposition affected fourteen patients and restrictive strabismus affected eleven patients. In this select group, improvement in diplopia occurred in 85.7% of cases with globe malposition and in 90.1% of cases with restrictive strabismus. One patient underwent additional strabismus surgery subsequent to orbital repair.

Conclusions: Post-traumatic diplopia in patients with prior orbital reconstruction can be successfully managed in appropriate patients with a high degree of success. Indications for surgical management include (1) globe malposition and (2) restrictive strabismus. High resolution computer tomography and Lancaster red-green testing discriminate these from other causes that are unlikely to benefit from orbital surgery.

研究设计:对曾接受眼眶外伤手术治疗而复视的患者进行眼眶再造手术结果的回顾性病历审查:我们的研究旨在回顾我们在处理曾接受过眼眶重建手术的复视患者的创伤后持续复视方面的经验,并提出一种新的患者分层算法,以预测更好的治疗效果:我们对约翰霍普金斯医院威尔默眼科研究所(Wilmer Eye Institute)和马里兰大学医学中心(University of Maryland Medical Center)2005-2020年间接受复视矫正眼眶手术的成年患者进行了回顾性病历审查。限制性斜视是通过兰卡斯特红-绿测试、计算机断层扫描和/或强迫抽吸来确定的。眼球位置通过计算机断层扫描进行评估。根据研究标准,确定了17名需要手术干预的患者:结果:14 名患者的眼球位置不正,11 名患者的局限性斜视。在这组选定的患者中,85.7%的球状体位置不正患者复视有所改善,90.1%的限制性斜视患者复视有所改善。一名患者在眼眶修复术后又接受了斜视手术:结论:对于曾接受过眼眶重建手术的患者来说,外伤后复视的治疗成功率很高。手术治疗的适应症包括:(1)眼球位置不正;(2)局限性斜视。高分辨率计算机断层扫描和兰卡斯特红-绿测试可将这些病因与其他不太可能从眼眶手术中获益的病因区分开来。
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引用次数: 0
Editorial. 社论
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2023-04-08 DOI: 10.1177/19433875231167030
Sat Parmar, Rui Fernandes
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引用次数: 0
Plastic and Maxillofacial Training for War-Zones - A Systematic Review. 战区整形和颌面培训 - 系统回顾。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2022-05-02 DOI: 10.1177/19433875221083416
Tiffanie-Marie Borg, Naveen Cavale, Ghassan Abu-Sittah, Ali Ghanem

Study design: Injuries sustained in war-zones are variable and constantly developing according to the nature of the ongoing conflict. Soft tissue involvement of the extremities, head and neck often necessitates reconstructive expertise. However, current training to manage injuries in such settings is heterogenous. This study involves a systematic review.

Objective: To evaluate interventions in place to train Plastic and Maxillofacial surgeons for war-zone environments so that limitations to current training can be addressed.

Methods: A literature search of Medline and EMBase was performed using terms relevant to Plastic and Maxillofacial surgery training and war-zone environments. Articles that met the inclusion criteria were scored then educational interventions described in included literature were categorised according to their length, delivery style and training environment. Between-group ANOVA was performed to compare training strategies.

Results: 2055 citations were identified through this literature search. Thirty-three studies were included in this analysis. The highest scoring interventions were over an extended time-frame with an action-oriented training approach, using simulation or actual patients. Core competencies addressed by these strategies included technical and non-technical skills necessary when working in war-zone type settings.

Conclusions: Surgical rotations in trauma centers and areas of civil strife, together with didactic courses are valuable strategies to train surgeons for war-zones. These opportunities must be readily available globally and be targeted to the surgical needs of the local population, anticipating the types of combat injuries that often occur in these environments.

研究设计:战区的受伤情况各不相同,并根据持续冲突的性质不断变化。四肢、头部和颈部的软组织损伤往往需要专业的整形技术。然而,目前在这种环境下处理创伤的培训各不相同。本研究是一项系统性综述:评估针对战区环境培训整形颌面外科医生的干预措施,以解决当前培训的局限性:方法:使用与整形和颌面外科医生培训及战区环境相关的术语对 Medline 和 EMBase 进行文献检索。对符合纳入标准的文章进行评分,然后根据篇幅、授课方式和培训环境对纳入文献中描述的教育干预措施进行分类。进行组间方差分析以比较培训策略。本次分析共纳入 33 项研究。得分最高的干预措施是在较长的时间范围内,采用行动导向的培训方法,使用模拟或实际病人。这些策略涉及的核心能力包括在战区环境中工作所需的技术和非技术技能:结论:在创伤中心和内乱地区进行外科轮转以及开设教学课程是培训战区外科医生的重要策略。这些机会必须在全球范围内随时提供,并以当地人口的外科需求为目标,预测在这些环境中经常出现的战伤类型。
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引用次数: 0
Nine Years of Retrospective Study of Mandibular Fractures in Semi-urban Teaching Hospital, Shimla, Himachal Pradesh, India. 印度喜马偕尔邦西姆拉半城市教学医院下颌骨骨折九年回顾性研究。
IF 0.9 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-06-01 Epub Date: 2022-05-03 DOI: 10.1177/19433875221095984
Narotam K Ghezta, Yogesh Bhardwaj, Rangila Ram, Monika Parmar, Rowena N Basi, Pooja Thakur

Study design: Retrospective study.

Objective: To evaluate current trends in maxillofacial trauma, a retrospective study of mandibular fractures at Government Dental College and Hospital Shimla H.P was carried out.

Methods: In this retrospective study, records of 910 patients with mandibular fractures were reviewed between 2007 and 2015 in the Department of Oral and Maxillofacial Surgery out of total 1656 facial fractures. These mandibular fractures were assessed according to age, sex, aetiology in addition to monthly and yearly distribution. Post-operative complications such as malocclusion, neurosensory disturbances and infection were recorded.

Results: It was observed that mandibular fractures were most frequent in males (67.5%) and in the age group of 21-30 years; accidental fall was the most common etiological factor (43.8%) in the present study and in stark difference to already published reports. The most common fracture site was that of condylar region 239 (26.2%). Open reduction and internal fixation (ORIF) were done in 67.3% cases whereas 32.6% were managed by maxillomandibular fixation and circummandibular wiring. Miniplate osteosynthesis was the most favoured technique. The complication with ORIF was 16%.

Conclusions: To treat mandibular fractures, currently there are many techniques. However, in minimizing complications and in achieving satisfactory functional and aesthetic results experienced surgical team plays an important role.

研究设计回顾性研究:为了评估颌面部创伤的当前趋势,对希姆莱政府牙科学院和医院的下颌骨骨折进行了回顾性研究:在这项回顾性研究中,口腔颌面外科回顾了 2007 年至 2015 年间 910 名下颌骨骨折患者的记录,其中面部骨折患者总数为 1656 人。根据年龄、性别、病因以及每月和每年的分布情况对这些下颌骨骨折进行了评估。此外,还记录了术后并发症,如咬合不正、神经感觉障碍和感染等:本研究发现,下颌骨骨折最常见于男性(67.5%)和 21-30 岁年龄组;意外摔倒是最常见的病因(43.8%),这与已发表的报告截然不同。最常见的骨折部位是髁突区 239 处(26.2%)。67.3%的病例采用了切开复位内固定术(ORIF),32.6%的病例采用了上颌骨固定术和颌周布线术。最常用的技术是微板骨合成术。ORIF的并发症发生率为16%:结论:目前治疗下颌骨骨折有多种技术。结论:目前,治疗下颌骨骨折的技术有很多,但在减少并发症、获得满意的功能和美观效果方面,经验丰富的手术团队发挥着重要作用。
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Craniomaxillofacial Trauma & Reconstruction
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