Trauma sites and clinical features associated with acute hyperextension spinal cord injury without bone damage--relationship between trauma site and severity.
To elucidate whether a relationship exists between the site of trauma and severity of acute hyperextension spinal cord injury without bone damage, we examined the clinical features of 25 male and 10 female patients aged 13 to 88 years. None of the patients had vertebral damage such as fracture and dislocation. The site of impact was classified as the buccal, forehead, or mandibular region. The neurological findings were assessed according to Frankel's classification at admission and at follow up after 3 months or more to assess outcome. Eleven patients suffered trauma in the buccal region, one patient in Frankel's grade B, three in grade C, and seven in grade D at admission. All 11 of these patients showed an improvement of one grade or more to an outcome of C in one patient, D in one, and E in nine. Trauma occurred at the forehead region in 18 patients, four in grade B, 10 in grade C, and four in grade D. Improvement was seen at follow up by one grade or more to C in one patient, D in 10, and E in seven. Trauma occurred at the mandibular region in six patients, four in grade B and two in grade C. Four of these patients showed improvement of one grade or more to grade B in one, grade C in four, and grade E in one. Overall, seven patients had poor outcomes, five of whom suffered trauma to the mandibular region, indicating that impact to the mandibular region tends to have an unfavorable clinical outcome. Our findings indicate that the site of trauma greatly influences the severity of hyperextension spinal cord injury. (+info)
Spontaneous bone regeneration of the mandible in an elderly patient: a case report and review of the literature.
Spontaneous bone regeneration is an unexpected phenomenon that may take place in large mandibular defects secondary to trauma and tumor resection. One explanation for this unusual healing course is that it may be derived from the mechanism of fracture healing. A review of the literature presents several factors that may influence this process, such as the presence of periosteum and bony fragments, mandibular stabilization, soft tissue protection, the presence of infection, and a young age. Previous reports of spontaneous mandibular regeneration have all taken place in relatively young patients (5-35 years old). This paper reports a case of spontaneous bone regeneration in a 58-year-old woman who sustained an injury to her mandible from an explosive blast, and presents some explanations on how such an event could take place. (+info)
THE TREATMENT OF FRACTURES OF THE MANDIBLE.
One hundred and eleven cases of mandibular fracture in 67 patients who were seen at the San Francisco General Hospital from 1960 to 1962 were reviewed. With the exception of two cases in which displaced fragments interfered with the mandibular range of motion, condylar fractures were successfully treated with closed reduction. Undisplaced fractures of the angle were treated successfully by intermaxillary fixation alone, but the significantly displaced fractures were treated by open reduction and interosseous wire fixation. Fractures of the anterior body and midbody were usually treated with closed reduction if adequate teeth were present for satisfactory intermaxillary fixation. Some fractures of the anterior body, particularly those in the region of the symphysis require open reduction because of the strong pull of the muscles in that area. In this series of patients, clinical infection and non-union were most commonly associated with fractures communicating with teeth. If open reduction is necessary, the results in this series suggest that it should be delayed until the oral tract left by extraction is healed. Prophylactic antibiotics did not appear to be of value in preventing infection or non-union in this small series of patients, although sufficient data were not available for a statistical conclusion. (+info)
Hemifacial spasm following a blow to the mandible causing blunt injury to the peripheral facial nerve.
A 40-year-old male presented with hemifacial spasm manifesting as paroxysmal spontaneous twitches in the left peribuccal region persisting for 3 months. The symptoms began 7 days after an accident, when a signboard hit his left mandibular angle. Physical examination showed no trauma-related change in his face, and no neurological abnormality except for the twitches. Magnetic resonance imaging also showed no abnormalities of the facial nerve and adjacent regions. Electrophysiological studies showed synkinesis, so hemifacial spasm caused by peripheral facial nerve injury was suspect- ed. The symptoms subsided 4 months after the injury. Blunt injury to the facial nerve branches might cause hemifacial spasm. (+info)
Loss of permanent mandibular lateral incisor and canine tooth buds through extraoral sinus: report of a case.
Extraoral sinus tract may occur as a result of an inflammatory process associated with the necrotic pulp. Several non odontogenic disorders may also produce an extraoral sinus tract, the differential diagnosis of these clinical findings is of prime importance in providing appropriate clinical care. Presented here is a case report of 4 year old female child with extraoral sinus tract through which the tooth buds of mandibular permanent left lateral incisor and mandibular permanent left canine were lost. The extraoral sinus was due to mandibular left primary canine with class IX fracture (Ellis and Davey's classification). (+info)
Orthognathic surgery for occlusal reconstruction of old malunited jaw fracture.
Old malunited jaw fractures of nine patients who underwent orthognathic surgery for occlusal reconstruction were clinically evaluated. Early surgery on fractures of the jaw is the optimal treatment when due attention must be paid to occlusion. Since occlusal revision surgery subsequent to inaccurate diagnosis and inappropriate surgery is certainly very difficult and often unsuccessful, surgeons need to pay special attention to this situation. (+info)
Defect repair in rat mandible with hydroxyapatite cement compared to small intestine submucosa.
AIM: The aim of this study was to evaluate the bone formation in surgically created defects of rabbit mandibles by synthetic hydroxyapatite of calcium compared to small Intestine Submucosa. MATERIAL AND METHOD: 24 mice lineage Wisthar-Furth were used. A bony defect of 0,75 cm x 1,5 cm in mandibular ramus was accomplished in all animals. The hydroxyapatite implants were placed on the left hemimandiblein group I, small Intestine submucosa in group II, and the right served as control. The euthanasia was accomplished in the 40 degrees postoperative day, it was proceeded the macroscopic and histological analysis. RESULTS: medium length in millimeters of the hemimandibless in the hydroxyapatite group was of 3,75, in the small intestine submucosa 3,03 and the control group was of 2,63 (p: 0,022). Histomorphometry study revealed new bone grown in 76,64% of the total area in hydroxyapatite group (p: 0,022). In Small Intestinal submucosa group new bone grown in 63,64% do total (p: 0,0022). DISCUSSION: satisfactory bone integration was observed of the synthetic hydroxyapatite in that experimental model. Small intestinal submucosa cause osteoinduction CONCLUSION: using hydroxyapatite of calcium resulted in formation of significantly larger volume fractions of new bone when compared to small intestinal submucosa group. (+info)
Evaluation of different rotary devices on bone repair in rabbits.
In oral surgery, the quality of bone repair may be influenced by several factors that can increase the morbidity of the procedure. The type of equipment used for ostectomy can directly affect bone healing. The aim of this study was to evaluate bone repair of mandible bone defects prepared in rabbits using three different rotary devices. Fifteen New Zealand rabbits were randomly assigned to 3 groups (n=5) according to type of rotary device used to create bone defects: I--pneumatic low-speed rotation engine, II--pneumatic high-speed rotation engine, and III--electric low-speed rotation engine. The anatomic pieces were surgically obtained after 2, 7 and 30 days and submitted to histological and morphometric analysis. The morphometric results were expressed as the total area of bone remodeling matrix using an image analysis system. Increases in the bone remodeling matrix were noticed with time along the course of the experiment. No statistically significant differences (p>0.05) were observed among the groups at the three sacrificing time points considering the total area of bone mineralized matrix, although the histological analysis showed a slightly advanced bone repair in group III compared to the other two groups. The findings of the present study suggest that the type of rotary device used in oral and maxillofacial surgery does not interfere with the bone repair process. (+info)