1/18. Unusual dental injuries following facial fractures: report of three cases.We report 3 cases of unusual dental injuries following facial fractures. The first patient sustained intrusion of a maxillary incisor into the nasal cavity following a mandibular fracture. The tooth dislocated into the pharynx and was found lodged in the piriform fossa during surgery. The second patient sustained intrusion of molars into the maxillary sinus following maxillary and mandibular fractures. His treatment was delayed due to life-threatening hemorrhage. The third case involved ingestion of multiple avulsed teeth into the alimentary tract following severe maxillofacial fractures. Although the diagnosis was made more than a week after the injury, the patient did not suffer any complications as a result of the dental avulsion. The aim of this report is to emphasize the possibility of associated dental injuries in patients with facial fractures. The trauma surgeon should be cognizant of the importance of carrying out a thorough intraoral examination during the initial evaluation. Any missing tooth should be considered as possibly displaced into other tissue compartments, and must be routinely searched for with x-rays of the skull, cervical spine, chest, and abdomen. If full intrusion injury is suspected, further diagnostic investigation with facial computed tomography scanning may be worth while.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/18. An unusual case of sub-condylar bilateral fracture and bilateral post-traumatic temporomandibular ankylosis.A case of bilateral sub-condylar fracture with wide stump dislocation associated with a central facial trauma, fracture-intrusion of the rhino-orbital-maxillary complex and a parasymphyseal mandibular fracture, is reported. After surgery and inter-maxillary fixation an unusual temporo-mandibular ankylosis developed. Maximum mouth opening, lateral and protrusive movements were severely limited. Surgical treatment of ankylosis was requested and performed. The originality of this case lies in the atypical lateral dislocation of condylar neck fractured stumps to the zygomatic arches and in the later appearance of ankylosis between the glenoid fossa, zygomatic arch, condylar neck stump, and the condylar process displaced anteromedially. The ankylosed blocks were resected, displaced condyles were also removed due to the strong adhesion with the ankylotic tissue and the lack of any anatomical continuity or connection with the glenoid fossa. Functional therapy allowed the resolution of the functional limitation.- - - - - - - - - - ranking = 54.127551020408keywords = mouth (Clic here for more details about this article) |
3/18. Intracapsular fractures of mandibular condyle: diagnosis, treatment, and anatomical and pathological evaluations.The aim of this study was to attempt to establish a correlation between condylar localized fracture, onset of anatomicopathological lesions of the articular structures, and determination of ankylosis so as to define appropriate diagnostic and therapeutic procedures. Clinical, arthroscopic, and histological studies were carried out in two patients with a severe temporomandibular joint disorder after a condylar localized fracture. Treatment included removal of the displaced fragments, condylar surface remodeling, suture of retrodiskal perforations, and diskal repositioning. The histological study of the condylar specimens revealed signs of osteoarthrosis of the articular surface and chondroid metaplasia of the bilaminar zone with early onset of ankylosis. Results of this study confirmed the presence of causal relations between condylar localized fracture and ankylosis with alterations in retrodiskal tissue. These relations are found in 1) tissue damage caused by bony fragments remaining in the articular cavity (underestimated and poorly treated fractures), 2) the lesion that occurs in association with mechanical trauma; and, particularly, c) the disk and retrodiskal impairments caused by catabolic and degenerative osteoarthrotic changes secondary to condylar marrow damage. Thus, timeliness and accuracy of the diagnosis of condylar localized fracture are most important, as are correct diagnosis and treatment before the onset of degenerative anatomicopathological lesions.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
4/18. Self-inflicted orodental injury in a child with leigh disease.leigh disease is an inherited progressive mitochondrial neurodegenerative disease that affects the neurological, respiratory and cardiovascular systems and is associated with retardation of the intellectual and physical development. This report describes the case of a 4-year-old boy with leigh disease who presented with self-inflicted traumatic injury to the teeth, alveolar bone, lips and tongue during repeated episodes of intense orofacial spasms. Conservative management of the injury included repositioning the fractured alveolar bone, splinting the traumatized teeth and planning for a mouthguard. However, after a second incident of severe self-induced injury to the teeth and alveolar bone, extraction of the anterior teeth became inevitable to protect the child from further self-mutilation and to allow healing of the injured tissues.- - - - - - - - - - ranking = 54.127551020408keywords = mouth (Clic here for more details about this article) |
5/18. Non-surgical treatment of mandibular fractures--survey of 28 patients.Between January 1996 and January 2001 28 patients (nine females, nineteen males) with 35 fractures were treated by observation and soft diet only. patients with isolated high condylar neck fractures were not included. The mean age at time of trauma was 35.6 years (5/80). Only patients with normal occlusion and radiologically undisplaced fractures were included. The follow-up time was 15 weeks on average (8/33). The patients did not undergo any active treatment. They just received the instruction to reduce mouth opening and to take a soft diet for 4 weeks. During the first 2 weeks after the trauma the patients were seen twice a week. Follow-up x-rays were performed after 4 and after 8 to 12 weeks. As a preemptive therapy antibiotics (amoxicillin plus clavulanic acid 2 x 1g/day) were given for 5 days. Spontaneous healing of all fractures was observed. In two patients a tooth had to be removed out of the fracture line. One patient complained about an occlusal problem after 1 week. In his case intermaxillary fixation was installed for 2 weeks. For forensic reasons the patients have to be fully informed about possible complications before indicating this type of management. patient selection is crucial and requires a highly experienced surgeon. Patient inconvenience due to frequent consultations must be taken into consideration. This type of treatment can be recommended only in selected cases.- - - - - - - - - - ranking = 54.127551020408keywords = mouth (Clic here for more details about this article) |
6/18. Spontaneous fracture of hypertrophied genial tubercles.A case of spontaneous fracture of hypertrophied genial tubercles is reported. This is an uncommon event with only six previously reported cases. This entity is usually associated with severe edentulous bone resorption, a condition related to the pathogenesis of this fracture. Clinical complaints include painful swelling of the floor of the mouth and impaired tongue function. If left untreated, mucosal inflammatory changes may appear and a biopsy should be performed. Total recovery is obtained after removal of the fractured fragments.- - - - - - - - - - ranking = 54.127551020408keywords = mouth (Clic here for more details about this article) |
7/18. Miniplate fixation of high condylar fracture and postoperative exercise regimen.The aim of this report is to present three cases of high condylar fracture treated with vertical ramus osteotomy, miniplate fixation of fractured condylar neck, and free grafting. The authors also introduce a simple and easy postoperative exercise regimen. A submandibular incision is made and the ascending ramus divided between the sigmoid notch and the angle of the mandible. After the fragment is removed, the dislocated head of the condyle is readily visible and can be retrieved. The reconstructed osteotomized ramus and condylar head can now be reinserted through the wound and plated. Intermaxillary fixation with arch bar is used. The length of the fixation period is about 14 days after surgery. At the end of this period, the bracket is applied to maxillary incisors, the occlusion becomes stable and reproducible, and then aggressive jaw-opening exercise begins. On postoperative day 21, elastics are applied 24 hours a day. They are placed lightly during the daytime to assist guiding protrusion of the mandible. The patient is instructed to protrude the mandible and to open the mouth simultaneously. The exercise is modified to lateral movement. After the bracket is removed on postoperative day 28, the patient exercises the chin laterally without any guiding elastic fixation for approximately 1 week. This regimen can be widely used in ostectomy-osteosynthesis cases.- - - - - - - - - - ranking = 54.127551020408keywords = mouth (Clic here for more details about this article) |
8/18. Enteric bacteria mandibular osteomyelitis.osteomyelitis of the mandible is a relatively rare inflammatory disease that usually stems from the odontogenic polymicrobial flora of the oral cavity. We are reporting 2 unusual cases of mandibular osteomyelitis resulting from enteric bacteria infection. In one patient, abundant clinical evidence suggested a diagnosis of a chronic factitious disease, whereas in the second patient no obvious etiology was found.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
9/18. Spontaneous fracture of genial tubercles: case report.A case is presented of fractured genial tubercles, revealed by occlusal radiography, in a 63-year-old edentulous woman. Isolated fractures are a rare event that may present with pain and edema in the floor of the mouth. It occurs mainly in patients wearing a complete denture when the mandible is atrophied and the genial tubercles are hypertrophied. Only 11 case reports have been found in the English literature.- - - - - - - - - - ranking = 54.127551020408keywords = mouth (Clic here for more details about this article) |
10/18. Aseptic osteomyelitis and necrosis of the mandibular condylar head after intracapsular fracture.Aseptic osteomyelitis and necrosis of the mandibular condylar head is a rare complication which may occur several months after an untreated intracapsular fracture. Clinical symptoms are pain in the temporomandibular joint on the affected side and limitation of opening of the mouth. Radiographically, the condylar head is characteristically eroded and irregular. Treatment consists of surgical removal of the necrotic condylar head and debridement of the area, which are performed via a preauricular approach.- - - - - - - - - - ranking = 54.127551020408keywords = mouth (Clic here for more details about this article) |
| | Next -> |