The management of mandibular body fractures in young children

Aizenbud, Dror; Hazan-Molina, Hagai; Emodi, Omri; Rachmiel, Adi

doi:10.1111/j.1600-9657.2009.00815.x

Cited by 50 publications

(78 citation statements)

References 42 publications

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“…The use of an arch bar and wire, followed by intermaxillary fixation, is an option for treatment of such fractures. [26][27][28] Disadvantages of arch bar intermaxillary fixation include an unacceptably high glove perforation rate associated with arch bar placement, risk of blood-borne pathogen infection in maxillofacial trauma, need for general anesthesia to place the arch bars, the effects of the arch bar on dental enamel and gingiva, increased discomfort, prolonged treatment, poor oral hygiene, and the likelihood of gingival injury. 6,28 The orthodontic bracketing that we used offers an acceptable and less threatening procedure to a pediatric patient and resulted in high patient comfort and acceptance.…”

Section: Discussionmentioning

confidence: 99%

Conservative orthodontic fixed appliance management of pediatric mandibular bilateral condylar fracture

Gong

Zhu

et al. 2016

American Journal of Orthodontics and Dentofacial Orthopedics

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Section: Discussionmentioning

confidence: 99%

Conservative orthodontic fixed appliance management of pediatric mandibular bilateral condylar fracture

Gong

Zhu

et al. 2016

American Journal of Orthodontics and Dentofacial Orthopedics

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“…However, the mandible has the capacity to heal rapidly in the early years of life, as the high osteogenic potential of the bone, large medullary space, and thick periosteum enable rapid consolidation and remodeling at a fracture site. 1,2 The immobilization time should thus be minimized to 2 to 3 weeks. 3 In the present patient, we left the occlusal splint in situ for 3 weeks, as recommended in reports of similar patients.…”

Section: Discussionmentioning

confidence: 99%

A Simplified Way for the Stabilization of Pediatric Mandibular Fracture With an Occlusal Splint

Demirkol

Abdo

et al. 2016

Journal of Craniofacial Surgery

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The management of pediatric mandibular fractures is challenging for maxillofacial surgeons due to ongoing mandibular growth involving tooth buds. The treatment of such fractures has been a topic of much research. Generally accepted methods for the treatment of mandibular parasymphyseal or symphyseal fractures in children are conservative approaches involving the use of acrylic splints, lateral compression with an open-cap splint stabilized by circummandibular wiring, and maxillomandibular fixation with an arch bar and eyelet wiring. The aim of this technical note was to describe a straightforward approach to the treatment of pediatric mandibular fractures, in which an occlusal splint is secured to prevent trauma to the soft tissue, without the need for general anesthesia.

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“…Mock surgery also needs to achieve proper reduction before acrylic splint fabrication (4,6). It may need more time while the laboratory working done.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, more conservative approach, such as minimal manipulation without affecting functional impairment, is mandatory in children (4).…”

Section: Discussionmentioning

confidence: 99%

Computer-assisted Virtual Surgery and Splint Fabrication for Paediatric Mandible Fracture

Lee¹

2015

Journal of International Society for Simulation Surgery

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IntroductionComputer-assisted virtual surgery is a rapidly emerging topic in the dentistry field (1). Recent developments of high resolution computed tomography (CT) has enabled a better understanding of the complex anatomical structure. The combination of high resolution CT, three-dimensional reformatted images, and stereolithographic models have improved the convenience and accuracy in oral and maxillofacial surgery (1, 2). This short communication reports a technique of computer-assisted virtual reconstruction and splint fabrication in a 2-year-old boy with mandibular fracture. Case ReportA 2-year-old boy with no systemic and familial history visited to our clinic with chief compliant of facial trauma due to fall down. Clinically, the left facial swelling was observed with limited mouth opening. There was tenderness to palpation on the right side of condylar area. Facial CT revealed the left mandibular body and the right condylar fracture. Closed reduction of fractured mandible was planned under general anesthesia.For virtual reconstruction, preoperative CT scans (1-mm fine cut) of the patients were obtained. Digital imaging and communication in medicine (DICOM) data obtained from the CT scans were imported into the Mimics 14.01 software (Materialise, Leuven, Belgium) to enable computer-assisted simulation, and the images were reconstructed to establish a three-dimensional virtual model (Fig. 1).A segmentation procedure was performed on the patient's virtual displaced mandible along the fracture line. The mandible segments were virtually reduced to the native anatomic mandible contour considering the occlusal relationship (Fig. 2). The computer-assisted design (CAD) image of the splint was drawn on the reduced virtual mandible model covering the mandibular teeth, and the generated data was saved as a stereolithographic file (Fig. 3). Finally, the splint used for mandibular reduction was fabricated using a rapid prototyping technique.Under general anesthesia, the patient placed in prefabricated splint with circummandibular wires, ensuring that the occlusion was centric and stable (Fig. 4). A postoperative facial CT was obtained to verify adapation of the fractured segments. A week later, the patient was discharged to home. Closed reduction using acrylic splints with circummandibular fixation has been known to be useful techniques in pediatric mandibular fractures. However, this technique has some shortcomings, including needs for impression taking or additional laboratory process, which can increase the exposure time of general anesthesia or make an additional sedation visit. Recently, the advancement of computer-aided maxillofacial surgery offers to clinicians to expansion of its application. This case report represents a technique of computer-assisted virtual reconstruction and computer-aided designed splint fabrication in a 2-yearold boy with mandibular body fracture.Key WordsZZPediatric mandibular fracture ㆍComputer-assisted surgery ㆍVirtual simulation.

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The management of mandibular body fractures in young children

Cited by 50 publications

References 42 publications

Conservative orthodontic fixed appliance management of pediatric mandibular bilateral condylar fracture

Conservative orthodontic fixed appliance management of pediatric mandibular bilateral condylar fracture

A Simplified Way for the Stabilization of Pediatric Mandibular Fracture With an Occlusal Splint

Computer-assisted Virtual Surgery and Splint Fabrication for Paediatric Mandible Fracture

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