A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Dentistry, Maxillo, Facial and Oral Surgery Johannesburg, 2017 / Introduction: The mandibular angle fracture remains one of the most common mandibular fractures with a reported incidence of ~20 – 40%. Its treatment is rife with controversy with a reported global complication rate of ~30%. Aim: The purpose of the study is to determine the optimum management of the compound, isolated mandibular angle fracture. Methods and materials: A prospective, randomised, study was carried out within the department where all cases of isolated, compound, mandibular angle fractures were allocated to 1 of the three treatment groups: Group1: Superior border wire; Group2: Single miniplate; Group3: Double miniplate. The patients were assessed for the presence of post-operative infection, malocclusion and fixation failure and the outcomes were correlated. The data was analysed statistically and reported upon using STATA. Results: 75 patients were included in the study with 25 patients per group. Complication rates were equal between the miniplate groups (16%), with the Superior border wire having the best outcomes. The average ―days to surgical fracture repair post-injury‖ (p = 0.08) and the category of ―severely displaced fractures‖ (>5mm) are the factors shown to increase the incidence of complications, p = 0.02. Overall a 13.3% complication rate was noted. Conclusion: The use of 2 miniplates seems to offer no benefit over a single miniplate. In stark contrast to previous global findings, fixation using a superior border wire with intermaxillary fixation (IMF) showed the best outcomes with a 92% success rate and its usage should be reaffirmed as a cost-effective alternative in a resource-constrained environment. / MT2017

Thesis (M Dent(MFOS))--University of Limpopo, 2010. / Introduction-Craniofacial reconstruction following trauma is different for each individual as it highly depends on the nature and location of the patient’s injuries. The mandible is a unique bone, which has a complex role in both esthetics of the face and functional occlusion. Due to the prominent position of the lower jaw, mandibular fractures are the most common fracture of the facial skeleton Aim- The aim of this study is to assess the prevalence and distribution of combination fractures in the mandible among patients presenting at the University of Limpopo, Medunsa Campus, department of Maxillofacial and Oral surgery. The nature and site of injuries occurring in the mandible will be recorded, and correlated with the cause of injury. The data should establish a preoperative idea of fractures that can be expected in the mandible when associated with a particular type of injury, especially of the combination type. Materials and methods- The patient’s records and radiographs at the University of Limpopo Medunsa Campus, Department of Maxillofacial and Oral Surgery (MFOS) were accessed. Patients with mandibular fractures who presented to the department over a four-year period (ranging from January 2002 to December 2005) were included in this study. Results- There were 1755 patients treated for maxillofacial injuries during the period 2002 to 2005 (4 years). A total of 1222 (69.63%) patients sustained fractures to the mandible. However 505 (41.33%) patients sustained combination fractures of the mandible. This evidence statistically proves that there is a 41.33% chance of another fracture occurring in a patient who has been diagnosed with a single fracture to the mandible. Various etiological factors contributed to these mandibular fractures. Interestingly the major contributing factor was found to be assault. This study confirms the results that males are affected more than females. This study found the average male to female ratio to be 8.18:1. The age distribution ranged from 2 years to 86 years. The mean age was found to be 31.07 years with a standard deviation of 12.06 years. The highest frequency was recorded between 20 to 29 years (42.77%) followed by 30 to 39 vi years (24.36%). The sites of fractures varied with different combinations. The highest number of fractures was recorded in the left angle (159) followed by the right parasymphysis region (142). In the combination category however the left angle right parasymphysis combination (70) showed the highest incidence of combination fractures followed by left parasymphysis and right angle combination (47), right angle and left body combination (37) and left angle and right body (36) combination fractures. The incidence of sustaining a left angle and right parasymphysis combination fracture is 13.86%. A total of 92 (18.22%) condyles sustained fractures with various combinations. Fifty fractures occurred on the left side while 42 occurred on the right side. Conclusion- In conclusion this study has shown that there is a 41.33% chance of a combination fracture occurring in a fractured mandible. These results are statistically high given the fact that the mandible is a commonly injured bone. Therefore careful evaluation of diagnostic radiographs is necessary since some fractures are not diagnosed clinically. This can help improve treatment outcomes and reduce possible postoperative complications.

Thesis (M.S.)--University of Michigan, 1959.

Thesis. / Includes reprints of 4 supporting articles. Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1955. / "Thesis prepared as a requirement ... in oral surgery."

Thesis (M.S.)--University of Michigan, 1959.

Thesis. / Includes reprints of 4 supporting articles. Includes bibliographies.

Orientador: Roger William Fernandes Moreira / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T16:02:50Z (GMT). No. of bitstreams: 1 Falci_SauloGabrielMoreira_D.pdf: 1799316 bytes, checksum: 1de035c12bc218e5f3759c843bc2025d (MD5) Previous issue date: 2014 / Resumo: O objetivo desse estudo foi comparar por meio de testes mecânicos e fotoelásticos o desempenho dos parafusos canulados cônicos utilizados na fixação de fraturas de sínfise mandibular com outros métodos de fixação. Dez mandíbulas de poliuretano foram utilizadas em cada grupo e fixadas da seguinte maneira: Grupo (PRP), duas miniplacas do sistema 2,0 mm, perpendiculares; Grupo (PLL), uma placa do sistema 2,4 mm e uma miniplaca do sistema 2,0 mm, paralelas; Grupo (PC), dois parafusos canulados cônicos do sistema 2,8 mm. Foram realizados testes de carregamento linear vertical em uma máquina de ensaio universal. O teste de ANOVA One-way e o teste de Tukey foram utilizados para verificar a diferença entre as médias. O teste fotoelástico foi realizado, com o auxílio de um polariscópio plano. Foi usada uma mandíbula de resina fotoelástica para cada grupo de fixação (PRP, PLL e PC). A avaliação dos dados do teste fotoelástico foi qualitativa e descritiva. Os resultados mostraram diferença entre os grupos (PC) e (PRP) nos deslocamentos de 1 mm (p=0,025), 3 mm (p=0,013), 5 mm (p=0,036) e 10 mm (p=0,022). No teste fotoelástico foi observada maior concentração de tensões na região próxima à base mandibular em todos os grupos. No grupo (PRP) e (PLL) foi observada maior concentração de tensões na região da placa mais próxima à base enquanto no grupo (PC) as franjas isocromáticas foram mais dispersas em toda região avaliada. De acordo com os resultados do estudo foi possível concluir que os parafusos canulados cônicos apresentaram um bom desempenho nos testes mecânicos e fotoelásticos, sendo uma opção viável para a fixação das fraturas de sínfise mandibular / Abstract: The aim of this study was to compare by mechanical and photoelastic tests, the performance of the cannulated screws in mandibular symphysis fractures and compare them with other fixations methods. Ten polyurethane mandibles were used in each group and fixed as follows: Group (PRP) 2 2.0-mm perpendicular miniplates; Group (PLL) 1 2.0-mm miniplate and 1 2.4-mm bone plate, parallels; Group (CS) 2 2.8-mm cannulated screws. Vertical linear loading tests were performed in a universal testing machine. Differences among means were analyzed by the One-Way ANOVA and Tukey test. The photoelastic test was carried out using a plane polariscope. One photoelastic mandible resin was used for each fixation group (PRP, PLL and CS). Data evaluation of the photoelastic test was qualitative and descriptive. The results showed differences between (CS) and (PRP) groups in 1 mm (p=0.025), 3 mm (p=0.013), 5 mm (p=0.036) and 10 mm (p=0.022), of displacement. The photoelastic test showed higher stress concentration, in all groups, close to mandibular base. In (PRP) and (PLL) groups, the stress concentration was observed closest to the plate fixed in mandibular basis, while the (CS) group showed more dispersed isochromatic fringes throughout the evaluated region. According to the results of this study, it was concluded that conical cannulated screws performed well in mechanical and photoelastic test, being a viable method for fixation of mandibular symphysis fractures / Doutorado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Doutor em Clínica Odontológica

Magister Chirurgiae Dentium - MChD / Mandibular fractures are common facial injuries, occurring twice as frequently as fractures of the bones of the midface. Only the nasal bones are fractured more often as the result of trauma to the face (Olson eta/ 1982; Theriorletal 1987; Shepherd et al 1988; Dodson et al 1990; Lownie et al 1996). In many oral and maxillofacial units, the treatment of fractures of the mandible form the major proportion of the services rendered. Internationally it is accepted that there are two methods of treatment for fractures of the mandible, namely, closed and open reduction. Closed reductions are performed in dentate patients either under local or general anaesthesia. This method entails the placement of eyelet wires between or around teeth in both arches and then placing the patient into intermaxillary fixation. This is the method of choice when treating an undisplaced fracture of the mandible.

Magister Scientiae Dentium - MSc(Dent) / Aim: The aim of the study was to compare immediate and delayed surgical management of septic mandibular fractures. Introduction: Infected mandible fractures can be treated via diverse protocols. Two recognized protocols are the so-called delayed approached and the immediate approach. In the delayed approach, sepsis is resolved first, followed by surgery. With the immediate approach, the sepsis is first drained, followed by open reduction and internal fixation of the jaw fracture in one continuous surgical procedure. Material and methods: 20 clinical cases where included in the study. Patients were randomly selected and assigned to the two treatment protocol groups. Pain, vital signs, fracture union, fracture stability, surgical time, hospital time, follow-up visits and patients’ demographics were recorded. Results: No statistically significant findings were made in the analysis of the demographic data and clinical parameters relating to the sepsis. The only significant data were related to the surgical time and hospital time. It was found that the advantages of the immediate approach versus the delayed approach related only to shorter surgical time and less days spent in hospital for the immediate approach. Conclusion: Septic mandibular fractures can be managed either by an immediate or a delayed approach. The immediate surgical approach seems to have an advantage over the delayed approach regarding the surgical time and hospital admission days.