Abstract:Iraq−Iran war resulted in more than 400,000 people requiring prolonged medical care in Iran.An international team of prominent reconstructive surgeons led by Paul Tessier, the founder of craniofacial surgery, was invited to Iran during the war by official organizations entitled to support war victims. This team provided up-to-date oral and maxillofacial rehabilitation to patients with severe trauma defects in the lower third of the face. We collected the medical notes of 43 patients operated on by the Tessier … Show more
“…Two articles had pooled their analysis for both mandibular and maxillary injuries and so were unable to isolate individual injuries. 12,13 The study characteristics can be seen in Table 2.Figure 1.PRISMA search.…”
Section: Resultsmentioning
confidence: 99%
“…Frontoparietal grafts were used in (n = 4); it was not documented whether these were pedicled and so it is not possible to determine whether these are vascularised or not vascularised bone grafts. 13…”
Section: Resultsmentioning
confidence: 99%
“…5,6,18 Effective debridement is required for combat-related maxillofacial wounds before considering reconstruction; within this study, all studies did not comment on the time to first debridement nor the number of debridements which are both pivotal aspects of management. 1,3,[11][12][13][14]…”
Section: Discussionmentioning
confidence: 99%
“…Frontoparietal grafts were used in (n = 4); it was not documented whether these were pedicled and so it is not possible to determine whether these are vascularised or not vascularised bone grafts. 13 A total of 13% (n = 22) of mandibular reconstructions had either failed partly or completely within the studies. Moreover, 21% (n = 34) of patients suffered from postoperative complications.…”
Section: Type Of Mandibular Reconstruction Usedmentioning
Study Design Systematic Review and Meta-Analysis. Objective There has been an increasing trend in maxillofacial injuries associated with combat trauma. Within the maxillofacial complex, the mandible is the most likely structure to be damaged during combat. The structural deficits as a result can be reconstructed with many options. These include vascularised bone grafts (VBGs), non-vascularised bone grafts (NVBGs), alloplastic implants, reconstruction bars and distraction osteogenesis. This study aimed to determine the common modality and efficacy of mandibular reconstruction in combat trauma-related defects. Methods A literature search was conducted on Pubmed, Prospero, Dynamed, DARE, EMBASE, COCHRANE and BMJ databases. Results A total of six articles met the inclusion criteria identifying 165 patients requiring mandibular reconstruction. Non-vascularised iliac bone graft (n = 137) was the most common method followed by ileac crest bone chips harvest using Dacron urethran osteomesh tray (n = 24) and frontoparietal grafts (n = 4). Meta-analysis of five out of six trials demonstrated an overall success rate of 85% (95% CI 79–90; I2 = 59%). A total of 13% (n = 22) of reconstructions failed either completely or partially and 21% (n = 34) of patients suffered postoperative complications. Conclusions NVBGs are a practical, cost-effective and favourable method of war zone management of mandibular defects with success rates comparable to those reported in the civilian literature. However, general trauma principles take precedence to rule out life-threatening injuries. Due consideration of patient factors, surgical factors, and available resources are required in the first-line management of combat-related mandibular defects.
“…Two articles had pooled their analysis for both mandibular and maxillary injuries and so were unable to isolate individual injuries. 12,13 The study characteristics can be seen in Table 2.Figure 1.PRISMA search.…”
Section: Resultsmentioning
confidence: 99%
“…Frontoparietal grafts were used in (n = 4); it was not documented whether these were pedicled and so it is not possible to determine whether these are vascularised or not vascularised bone grafts. 13…”
Section: Resultsmentioning
confidence: 99%
“…5,6,18 Effective debridement is required for combat-related maxillofacial wounds before considering reconstruction; within this study, all studies did not comment on the time to first debridement nor the number of debridements which are both pivotal aspects of management. 1,3,[11][12][13][14]…”
Section: Discussionmentioning
confidence: 99%
“…Frontoparietal grafts were used in (n = 4); it was not documented whether these were pedicled and so it is not possible to determine whether these are vascularised or not vascularised bone grafts. 13 A total of 13% (n = 22) of mandibular reconstructions had either failed partly or completely within the studies. Moreover, 21% (n = 34) of patients suffered from postoperative complications.…”
Section: Type Of Mandibular Reconstruction Usedmentioning
Study Design Systematic Review and Meta-Analysis. Objective There has been an increasing trend in maxillofacial injuries associated with combat trauma. Within the maxillofacial complex, the mandible is the most likely structure to be damaged during combat. The structural deficits as a result can be reconstructed with many options. These include vascularised bone grafts (VBGs), non-vascularised bone grafts (NVBGs), alloplastic implants, reconstruction bars and distraction osteogenesis. This study aimed to determine the common modality and efficacy of mandibular reconstruction in combat trauma-related defects. Methods A literature search was conducted on Pubmed, Prospero, Dynamed, DARE, EMBASE, COCHRANE and BMJ databases. Results A total of six articles met the inclusion criteria identifying 165 patients requiring mandibular reconstruction. Non-vascularised iliac bone graft (n = 137) was the most common method followed by ileac crest bone chips harvest using Dacron urethran osteomesh tray (n = 24) and frontoparietal grafts (n = 4). Meta-analysis of five out of six trials demonstrated an overall success rate of 85% (95% CI 79–90; I2 = 59%). A total of 13% (n = 22) of reconstructions failed either completely or partially and 21% (n = 34) of patients suffered postoperative complications. Conclusions NVBGs are a practical, cost-effective and favourable method of war zone management of mandibular defects with success rates comparable to those reported in the civilian literature. However, general trauma principles take precedence to rule out life-threatening injuries. Due consideration of patient factors, surgical factors, and available resources are required in the first-line management of combat-related mandibular defects.
“…The leader of this team was Paul Tessier, the founder of craniofacial surgery. During this project, patients with severe trauma injuries in the lower part of the face were provided with MF and oral rehabilitation using the most current techniques (Simon et al, 2015). There are differences in the incidence rates of trauma according to countries worldwide.…”
Craniofacial deformities (CFDs) develop following oncological resection, trauma, or congenital disorders. Trauma is one of the top five causes of death globally, with rates varying from country to country. They result in a non-healing composite tissue wound as they degenerate in soft or hard tissues. Approximately one-third of oral diseases are caused by gum disease. Due to the complexity of anatomical structures in the region and the variety of tissue-specific requirements, CFD treatments present many challenges. Many treatment methods for CFDs are available today, such as drugs, regenerative medicine (RM), surgery, and tissue engineering. Functional restoration of a tissue or an organ after trauma or other chronic diseases is the focus of this emerging field of science. The materials and methodologies used in craniofacial reconstruction have significantly improved in the last few years. A facial fracture requires bone preservation as much as possible, so tiny fragments are removed initially. It is possible to replace bone marrow stem cells with oral stem cells for CFDs due to their excellent potential for bone formation. This review article discusses regenerative approaches for different types of craniofacial diseases.
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