The purpose of this study was to assess the epidemiological data on maxillofacial injuries related to road traffic accidents from two multispecialty medical centers in India, and then evaluate their incidence and pattern. Data were extracted from the medical records of all road traffic accident victims with maxillofacial injuries who reported to the centers between January 2013 and December 2017. Descriptive statistics and chi-square test were used for statistical analysis; significance was set at p < 0.05. Out of 1,110 patients, highest incidence of injuries was observed in the males of age group 20 to 29 years with mean age of 25.95 years (standard deviation, 9.35 years). Head injury, laceration, and tooth luxation were the most common forms of associated injuries. The use of protective helmets and seatbelts was extremely low which was associated to higher risk of facial bone fractures. Violation of traffic rules was the most common etiology behind these accidents. These findings were statistically significant ( p < 0.05). The ever increasing incidence of maxillofacial injuries related to road traffic accidents suggests the need to deal with them promptly and wisely. Keeping an update on the changing pattern of these injuries by continuous recording and periodic evaluation of epidemiological data is helpful in the primary prevention of trauma by evolving a better trauma care program and effective treatment protocol focused on the target groups. The updated data can guide treating physicians in anticipating and diagnosing maxillofacial injuries.
Study Design: Retrospective cohort study. Objective: The purpose of this study was to evaluate and share our experience with the surgery first approach (SFA) for correction of skeletal malocclusion. Methods: After consultation with the department of orthodontics, 45 patients with skeletal malocclusions suitable to undergo SFA were enrolled in this study (14 bimaxillary protrusion and 31 skeletal class III malocclusion). Le Fort I maxillary osteotomy, bilateral sagittal split ramus osteotomy, subapical osteotomy, and genioplasty were performed as required. After a healing period of 2 weeks, postoperative orthodontic treatment was started to achieve the final occlusion. Results: The mean duration of postoperative orthodontic treatment was 15.2 months, which is much shorter than the conventional orthodontic first approach (OFA) where presurgical orthodontic duration alone takes 12-24 months according to an individual. In the bimaxillary protrusion group, it was 18 months, which was significantly longer than for the other group ( P < .05). Conclusions: SFA offers an efficient alternative to conventional OFA with shorter total treatment duration, immediate marked improvement in facial profile, reduced biological costs, and similar operative stability. However, it comes at the cost of heightened challenges regarding case selection, accurate prediction, and surgical precision. With a joint venture between skilled and experienced surgeons and orthodontists, the outcome can be very promising.
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