Publications by authors named "Fabio Roccia"

70 Publications

Surgical Management of Mandibular Angle Fractures: Does the Extraction of the Third Molar Lead to a Change in the Fixation Pattern? A European Multicenter Survey.

J Oral Maxillofac Surg 2021 02 17;79(2):404-411. Epub 2020 Sep 17.

Assistant Professor, Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria.

Purpose: The authors conducted a retrospective, multicenter study to investigate the differences in the fixation patterns, in terms of number and thickness of plates, between patients in whom a third molar (3M) was maintained or removed in the line of mandibular angle fractures.

Materials And Methods: The study was conducted in 6 European level I and II maxillofacial trauma centers. Data were collected on patients ≥ 16 years of age who underwent open reduction internal fixation (ORIF) for mandibular angle fractures (MAF) from 2008 to 2018, in whom a 3M in the fracture line was present and who had a follow-up duration of 6 months. The study population was divided into 2 groups: patients treated with ORIF in whom the 3M was maintained (group 1) and those treated with ORIF in whom the 3M was extracted (group 2) during treatment. The 2 groups were compared for differences in the internal fixation pattern, specifically in terms of the number and thickness of the plates.

Results: A total of 749 patients with 774 MAF were collected. A total of 1,050 plates were placed: 849 were ≤ 1.4 mm thick (80.9%) and 201 plates ≥ 1.5 mm thick (19.1%). 548 patients were treated with ORIF and 3M maintained (group 1), and 201 treated with ORIF and 3M extracted (group 2). Statistically significant differences were seen in the number of ≤1.4 mm plates between the 2 groups for single undisplaced/displaced MAF(P value ≤ 0.5) and for undisplaced/displaced angle + parasymphysis/body fractures (P-value ≤ 0.5).

Conclusions: Analyses of data collected from 6 European maxillofacial centers indicated that the majority of surgeons of our sample perceived the MAF as being more unstable when removing the 3M during ORIF leading them to perform a rigid fixation in the angular region.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.joms.2020.09.022DOI Listing
February 2021

Surgical Management of Bilateral Mandibular Angle Fractures With a Third Molar in Line of Fracture: A European Multicenter Survey.

J Oral Maxillofac Surg 2021 Jan 7;79(1):201.e1-201.e5. Epub 2020 Sep 7.

Assistant Professor Dpt. of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria.

Purpose: The aim of this survey was to investigate the surgical management of bilateral mandibular angle fracture (BMAF) in Europe.

Methods: Data were collected from 2008 to 2018 on patients ≥ 16 years of age who underwent open reduction internal fixation (ORIF) for BMAF with a third molar in the fracture line. The study was conducted at 6 European trauma centers. The following data were recorded: sex, age, cause of the fracture, type of fracture (nondisplaced, displaced, comminuted), type of approach (intraoral, transbuccal, or extraoral), thickness of the plate (≤1.4 mm or ≥1.5 mm), number of plates, cause of plate removal, and third molar extraction status.

Results: 25 patients with BMAF (24 males, 1 female, 17 to 83 years old [mean: 28.2 years]) were collected. The main cause of BMAF was assault, and the main surgical approach was intraoral. The most common types of BMAF were displaced + undisplaced (11 patients), displaced + displaced (7 patients), undisplaced + undisplaced (6 patients), and comminuted + comminuted (1 patient). Osteosynthesis was performed with 2 ≤1.4 mm plates on 1 angular fracture and 1 ≤1.4 mm plate on the other fracture in 11 patients, 1 ≤1.4 mm plate on both angular fractures in 6 patients, 1 ≥1.5 mm plate on both fractures in 5 patients, and 2 ≤1.4 mm plates on both fractures in the remaining 3 patients. Out of 25 patients with BMAF, 7 third molars were extracted during ORIF. Among these patients, angular fracture fixation was performed in 3 cases with 1 ≥1.5 mm plate and in 4 patients with 2 ≤1.4 mm plates.

Conclusions: This retrospective multicenter survey indicates a trend of treating with open reduction and rigid internal fixation at least 1 angular fracture of BMAF and those cases requiring extraction of the third molar in the line of fracture.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.joms.2020.09.003DOI Listing
January 2021

Comprehensive analyses of maxillofacial fractures due to non-professional sports activities in Italy.

Dent Traumatol 2020 Dec 11;36(6):632-640. Epub 2020 Sep 11.

Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Torino, Italy.

Background/aim: Sports activities have become increasingly popular among amateurs and this has led to an increase in maxillofacial fractures. The aim of this study was to investigate the management of amateur sport-related maxillofacial fractures and appropriate preventive measures.

Methods: A trauma database was used to analyze 3231 patients with maxillofacial fractures admitted to the Maxillofacial Surgery Division of Città della Salute e della Scienza Hospital, Turin, Italy, from January 2001 to December 2019. Only patients with non-professional sports-related maxillofacial fractures were included. The following data were collected: age, gender, type of sport, mechanisms of injury, sites of fracture, Facial Injury Severity Scale, associated injuries, month of trauma, time to treatment, treatment, length of stay, and interval before return to sport.

Results: There were 432 patients, 378 males and 54 females, with a mean age of 29.2 (5-76 years). Sport-related maxillofacial fractures' relative percent ranged from 11.1% in 2001 to 17.5% in 2019. Soccer was the most common cause of sport-related maxillofacial fractures (54.2%), and impact with a player/opponent was the main mechanism of injury (72%). An intentional violent act (player hit by a fist) was the cause of fracture in 8.5% of the soccer-related injuries. Fractures of the middle third of the face occurred in 61.2% of patients. Maxillofacial fractures were treated within 24 h in 25% of patients. There were 343 out of 412 patients who received open reduction and internal fixation (mean length of hospital stay: 3.7 days). There was no contraindication to resuming sport activities at 30/40 days after treatment, except for combat sports.

Conclusions: This study provided further evidence of a relative increase in sports-related maxillofacial fractures. Soccer is related to the majority of sport maxillofacial fractures. Adherence to the rules is necessary to limit violent acts that cause such injuries. In non-professional players, resumption of the full activity is allowed after 40 days for non-combat sports.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/edt.12586DOI Listing
December 2020

Surgical Management of the Peripheral Osteoma of the Zygomatic Arch: A Case Report and Literature Review.

Case Rep Surg 2019 18;2019:6370816. Epub 2019 Jun 18.

Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e delle Scienza Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126 Torino, Italy.

An osteoma is a benign, slow-growing, osteogenic neoplasm with a low recurrence rate that is typically characterized by the proliferation of a compact or cancellous bone. It can be peripheral, central, or extraskeletal. Usually asymptomatic, peripheral osteomas in the maxillofacial region commonly arise in the paranasal sinuses and mandible and rarely occur in the zygomatic arch, with only six previously documented cases in the literature. Here, we present the management of a solitary peripheral osteoma of the right zygomatic arch in a 72-year-old woman and a review of the literature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2019/6370816DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604424PMC
June 2019

Maxillofacial Injuries Due to Traffic Accidents.

J Craniofac Surg 2019 Jun;30(4):e288-e293

Division of Maxillofacial Surgery, Surgical Science Department, Città della Salute e delle Scienze Hospital.

Purpose: The purpose of this retrospective study was to analyze the epidemiology, patterns, and management of maxillofacial due to road traffic accidents over a 17-year period.

Methods: Between January 2001 and December 2017, 2924 patients with maxillofacial fractures were admitted to the Division of Maxillofacial Surgery, Turin, Italy.The following data were analyzed: age, gender, data of the trauma, alcohol and drug abuse, mechanism of injury, fracture site, facial injury severity scale, associated injuries, type of treatment, and length of hospital stay.

Results: Of the 605 patients included in the study, 419 were male and 186 were female (ratio, 2.2:1). The most common mechanism of injury was car accidents (62.6%).More than half of the patients had fractures of the middle third of the maxillofacial skeleton.Associated injuries were detected in 172 (45.5%) patients. In total 5.3% of patients did not undergo surgery. The average hospital stay was 7.3 days.

Conclusions: This study shows an important reduction in maxillofacial fractures following road traffic accidents since the turn of the new millennium. At least in north-western Italy, road safety policies implemented in the last 30 years seem to have affected the behavior of motorists and motorcyclists.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000005158DOI Listing
June 2019

Management of atrophic mandibular fractures: An Italian multicentric retrospective study.

J Craniomaxillofac Surg 2018 Dec 25;46(12):2176-2181. Epub 2018 Sep 25.

O.U. of Maxillofacial Surgery, S Gerardo Hospital - Monza, Department of Medicine and Surgery (School of Medicine and Surgery), University of Milano Bicocca, Milan, Italy.

Purpose: The aim of this multicentric study was to retrospectively evaluate the surgical outcome of atrophic mandible fractures treated with open reduction and rigid fixation (ORIF), using load-bearing plates.

Materials And Methods: 55 patients from three trauma centers were retrieved for the study. Inclusion criteria were: edentulous patients with mandibular body fractures; mandibular body thickness <20 mm. Collected data included: cause of fracture; degree of atrophy (according to Luhr's classification); characteristics of the fracture; adequacy of reduction; postoperative complications. All patients were treated with ORIF, using 2.0 mm, large-profile, locking bone plates and 2.4 mm locking bone plates. No bone graft was used in any case.

Results: 12 patients were classified as class I atrophy, 18 patients as class II, and 25 patients as class III. Mean mandibular height at the site of fracture was 12.8 mm (ranging from 5.4 mm to 20 mm). 22 were unilateral fractures and 23 were bilateral. Mild displacement was observed in 11 fractures, moderate in 34, severe in 16, and comminution was present in seven fractures. Adequacy of reduction was judged good in 62 fractures and poor in six fractures. Transient weakness of the marginal branch of the facial nerve was recorded in 11 patients and permanent weakness in two patients. All patients achieved a complete fracture healing.

Conclusion: External open reduction and rigid fixation (ORIF) with locking, load-bearing plates is a reliable and predictable treatment for atrophic edentulous mandible fracture. Immediate bone grafting should not be considered mandatory unless there is consistent bone loss.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcms.2018.09.020DOI Listing
December 2018

Epithelioid Hemangioma of the Face.

J Craniofac Surg 2018 Nov;29(8):e736-e739

Division of Maxillo-Facial Surgery, Surgical Science Department, Città della Salute e della Scienza Hospital, University of Turin, Italy.

An epithelioid hemangioma is a very rare lesion arising from vascular structures. We encountered 2 cases in atypical locations, one in the orbital and the other in the nasal region. We performed preoperative angiography in addition to the diagnostic imaging recommended in the literature. Angiography highlighted the lesions well, and in one case, it was possible to embolize the arterial trunk of a high-flow lesion. Angiography underscored how such lesions may differ from the vascular perspective, emphasizing the importance of histology in correct diagnosis. Management of both hemangiomas yielded good functional and cosmetic outcomes with no disease recurrence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000004645DOI Listing
November 2018

Comparison of the Outcomes of Complex Orbital Fracture Repair with and without a Surgical Navigation System: A Prospective Cohort Study with Historical Controls.

Plast Reconstr Surg 2017 Apr;139(4):957-965

Torino, Italy.

Background: In severe orbital fractures, restoration of orbital shape and volume is required to avoid diplopia and posttraumatic enophthalmos. The purpose of this study was to compare outcomes between navigation-aided and conventional techniques for complex unilateral orbital fractures using titanium mesh.

Methods: The outcomes and the computed tomography-measured orbital volume of two groups of orbital complex unilateral reconstruction cases were compared. The study group consisted of a consecutive cohort of unilateral severe orbital fracture that underwent surgery with the aid of a Brainlab navigation system. A historical control group was composed of consecutive operations performed immediately before the beginning of navigation system use. A total of 55 operations were then identified and studied for patient characteristics, diplopia and globe position, preoperative and postoperative orbital volumes, complications, need for revision surgery, and the surgeon's performance.

Results: Postoperative diplopia severity was lower in the study group than in the control group. Orbital volume analysis showed that reconstructed orbital volume in the study group was closer to unaffected orbital volume compared with the control group. Significant orbital volume reduction in the reconstructed orbit could be achieved in the study group, and there was no significant reduction in the control group compared with the unaffected side. The globe projection was higher compared with the preoperative situation in the study group than in the control group. The navigational platform could also contribute to reduce the learning curve.

Conclusion: This study demonstrated that computer-assisted techniques improve outcomes compared with conventional techniques.

Clinical Question/level Of Evidence: Therapeutic, III.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/PRS.0000000000003229DOI Listing
April 2017

Surgical Management of Unusual Biangular Mandibular Fractures.

Case Rep Surg 2017 19;2017:6149838. Epub 2017 Feb 19.

Division of Maxillofacial Surgery, Surgical Science Department, Città Della Salute e Della Scienza Hospital, University of Torino, Torino, Italy.

Bilateral mandibular angle fractures, while representing a rarity among mandibular fractures, are a huge challenge of complex management for the maxillofacial surgeon. There are still many open questions regarding the ideal management of such fractures, including the following: the removal of the third molar in the fracture line, the best surgical approach, and the fixation methods. In this report the authors present the case of 40-year-old man presenting with a bilateral mandibular angle fracture referred to the Maxillofacial Surgery Department of Turin. Open reduction and internal fixation has been made for both sides. The left side third molar was removed and the internal fixation was achieved through internal fixation with one miniplate according to Champy's technique and transbuccal access for a 4-hole miniplate at the inferior border of the mandible. Right side third molar was not removed and fixation was achieved through intraoral access and positioning of a 4-hole miniplate along the external ridge according to Champy. An optimal reduction was achieved and a correct occlusion has been restored.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2017/6149838DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337380PMC
February 2017

An analysis of 711 victims of interpersonal violence to the face, Turin, Italy.

J Craniomaxillofac Surg 2016 Aug 6;44(8):1025-8. Epub 2016 Jun 6.

PhD programme in Technologies Applied to Surgical Science, Division of Maxillofacial Surgery, University of Torino, Italy. Electronic address:

Aim: The aim of this work is to analyze the risk factors in interpersonal violence and to describe the epidemiology, patterns and management of maxillofacial fractures in high volume trauma center of the northern Italy.

Material: This retrospective study recorded patients hospitalized with maxillofacial fractures, at the division of maxillofacial surgery, Città della Scienza e della Salute University Hospital, Torino, Italy, since January 2001.

Methods: Only patients who presented with "violence" in the database field for "cause of injury" and with "interpersonal violence" as a subtype of etiology were considered. Statistical analysis was determined using the χ(2) or Fisher's exact test.

Results: 2567 patients were admitted. 711 patients (27.7%) had undergone interpersonal violence that has increased from 20% to 35% in the study period. The male-to-female ratio was 11:1; the mean age was 32.7. 247 patients were foreigners (34.7%). 107 patients were enrolled in that study, referred alcohol or drugs abuse. IPV episodes account for 953 maxillofacial fractures localized in 55.3% of the cases in the midface, 43.1% in the lower third. Particularly the trauma involved the orbital region and the maxillo-orbito-zygomatic region. 4.4% of patients had combined trauma.

Conclusion: IPV maxillofacial fractures in Europe such as in Italy are becoming one of the first cause of injuries. This study shows that young males and foreigners are involved in violence mostly during the weekend. These fractures occur due to fists frequently involving the maxillo-zygomatic-orbital complex.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcms.2016.05.021DOI Listing
August 2016

European Maxillofacial Trauma (EURMAT) in children: a multicenter and prospective study.

Oral Surg Oral Med Oral Pathol Oral Radiol 2015 May 24;119(5):499-504. Epub 2014 Dec 24.

Department of Maxillofacial surgery, Stomatology Clinic, Tartu University, Tartu, Estonia.

Objective: The aim of this study is to present and discuss the results of a European multicentre prospective study about pediatric maxillofacial trauma epidemiology during a year.

Study Design: The following data were recorded: gender, age, etiology, site of fracture, date of injury. Of the 3396 patients with maxillofacial fractures admitted within the study period, 114 (3.3%) were children aged 15 years and younger, with a male/female ratio of 2.6:1. Mean age was 10.9 years. Most patients (63%) were aged 11-15 years.

Results: The most frequent cause of injury was fall (36 patients). Sport injuries and assaults were almost limited to the oldest group, whereas falls were more uniformly distributed in the 3 groups. The most frequently observed fracture involved the mandible with 47 fractures. In particular, 18 condylar fractures were recorded, followed by 12 body fractures.

Conclusions: Falls can be acknowledged as the most important cause of facial trauma during the first years of life. The high incidence of sport accidents after 10 years may be a reason to increase the use of mouthguards and other protective equipment. Finally, the mandible (and in particular the condyle) was confirmed as the most frequent fracture site.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.oooo.2014.12.012DOI Listing
May 2015

Assault-related maxillofacial injuries: the results from the European Maxillofacial Trauma (EURMAT) multicenter and prospective collaboration.

Oral Surg Oral Med Oral Pathol Oral Radiol 2015 Apr 11;119(4):385-91. Epub 2014 Dec 11.

Department of Maxillofacial surgery, Stomatology Clinic, Tartu University, Tartu, Estonia.

Objective: The aim of this study is to present and discuss the demographic characteristics and patterns of assault-related maxillofacial fractures as reported by a European multicenter prospective study.

Study Design: Demographic and injury data were recorded for each patient who was a victim of an assault.

Results: Assaults represented the most frequent etiology of maxillofacial trauma with an overall rate of 39% and the values ranging between 60.8% (Kiev, Ukraine) and 15.4% (Bergen, Norway). The most frequent mechanisms of assault-related maxillofacial fractures were fists in 730 cases, followed by kicks and fists. The most frequently observed fracture involved the mandible (814 fractures), followed by orbito-zygomatic-maxillary complex fractures and orbital fractures.

Conclusions: Our data confirmed the strong possibility that patients with maxillofacial fractures may be victims of physical aggression. The crucial role of alcohol in assault-related fractures was also confirmed by our study.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.oooo.2014.12.004DOI Listing
April 2015

Maxillofacial Fractures due to Falls: does Fall Modality Determine the Pattern of Injury?

J Oral Maxillofac Res 2014 Oct-Dec;5(4):e5. Epub 2014 Dec 29.

Surgical Science Department, San Giovanni Battista Hospital, University of Turin, Turin Italy.

Objectives: In several epidemiological studies of maxillofacial trauma, falls were one of the most frequent causes of facial injury. The aim of this study is to analyse the patterns of fall-related maxillofacial injuries based on the height of the fall.

Material And Methods: Using a systematic computer-assisted database of patients hospitalised with maxillofacial fractures, only those with fall-related injuries were considered. The falls were divided into four groups: falls from slipping, tripping or stumbling (STSF), loss of consciousness (LOCF), stairs (SAF), and height (HF). Data on the age, gender, fracture site, Facial Injury Severity Scale (FISS), facial lacerations, associated lesions, type of treatment, and length of hospital stay were also analysed.

Results: This study included 557 patients (338 males, 219 females; average age 51.5 years [range 4 - 99 years]). In the over 60 age group, females were more prevalent in STSF than males. According to aetiology, STSF was the most frequent cause of maxillofacial fractures (315 patients; 56.5%) followed by LOCF (157; 28.2%), HF (55; 9.9%), and SAF (30; 5.4%). The middle third of the face was affected most frequently. After LOCF, however, the inferior third was prevalently involved. The majority of associated fractures, as well as the most severe injuries and greatest rate of facial lacerations, occurred secondary to HF.

Conclusions: This study showed that fracture severity and site are influenced not only by patient age, but also by the nature of the fall.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5037/jomr.2014.5405DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306323PMC
January 2015

Orbital trapdoor fracture: can it occur also in adults?

J Craniofac Surg 2015 Jan;26(1):e6-8

From the Division of Maxillofacial Surgery, Department of Surgical Science, Città della Salute e della Scienza Hospital, University of Torino, Torino, Italy.

We describe here a peculiar case of a 30-year-old woman presenting with an orbital trapdoor fracture. Preoperative and postoperative magnetic resonance images are provided to explain the mechanism of the injury.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000001215DOI Listing
January 2015

Mandibular trauma treatment: a comparison of two protocols.

Med Oral Patol Oral Cir Bucal 2015 Mar 1;20(2):e218-23. Epub 2015 Mar 1.

Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry, Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands,

Objectives: The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years.

Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two centers in Turin, Italy and in Amsterdam, the Netherlands for ten years. Only patients who were admitted for mandibular fractures were considered for this study.

Results: Between 2001 and 2010, a total of 752 patients were admitted at Turin hospital with a total of 1167 mandibular fractures not associated with further maxillofacial fractures, whereas 245 patients were admitted at Amsterdam hospital with a total of 434 mandibular fractures. At Amsterdam center, a total of 457 plates (1.5 - 2.7 mm) were used for the 434 mandibular fracture lines, whereas at Turin center 1232 plates (1.5 - 2.5 mm) were used for the management of the 1167 mandibular fracture lines. At Turin center, 190 patients were treated primarily with IMF, whereas 35 patients were treated with such treatment option at Amsterdam center.

Conclusions: Current protocols for the management of mandibular fractures are quite efficient. It is difficult to obtain a uniform protocol, because of the difference of course of each occurring fracture and because of surgeons' experiences and preferences. Several techniques can still be used for each peculiar fracture of the mandible.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393986PMC
http://dx.doi.org/10.4317/medoral.20263DOI Listing
March 2015

European Maxillofacial Trauma (EURMAT) project: a multicentre and prospective study.

J Craniomaxillofac Surg 2015 Jan 22;43(1):62-70. Epub 2014 Oct 22.

Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.

The purpose of this study was to analyse the demographics, causes and characteristics of maxillofacial fractures managed at several European departments of oral and maxillofacial surgery over one year. The following data were recorded: gender, age, aetiology, site of facial fractures, facial injury severity score, timing of intervention, length of hospital stay. Data for a total of 3396 patients (2655 males and 741 females) with 4155 fractures were recorded. The mean age differed from country to country, ranging between 29.9 and 43.9 years. Overall, the most frequent cause of injury was assault, which accounted for the injuries of 1309 patients; assaults and falls alternated as the most important aetiological factor in the various centres. The most frequently observed fracture involved the mandible with 1743 fractures, followed by orbital-zygomatic-maxillary (OZM) fractures. Condylar fractures were the most commonly observed mandibular fracture. The results of the EURMAT collaboration confirm the changing trend in maxillofacial trauma epidemiology in Europe, with trauma cases caused by assaults and falls now outnumbering those due to road traffic accidents. The progressive ageing of the European population, in addition to strict road and work legislation may have been responsible for this change. Men are still the most frequent victims of maxillofacial injuries.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcms.2014.10.011DOI Listing
January 2015

Inferior alveolar nerve injuries associated with mandibular fractures at risk: a two-center retrospective study.

Craniomaxillofac Trauma Reconstr 2014 Dec 5;7(4):280-3. Epub 2014 Jun 5.

Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands.

The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments-Department of Maxillofacial Surgery, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands, and Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy. Demographic, anatomic, and etiology variables were considered for each patient and statistically assessed in relation to the neurosensory IAN impairment. Statistically significant associations were found between IAN injury and fracture displacement (p = 0.03), isolated mandibular fractures (p = 0.01), and angle fractures (p = 0.004). A statistically significant association was also found between IAN injury and assaults (p = 0.03). Displaced isolated mandibular angle fractures could be considered at risk for increased incidence of IAN injury. Assaults seem to be the most important etiological factor that is responsible for IAN lesions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0034-1375169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221141PMC
December 2014

Fractures of the mandibular coronoid process: a two centres study.

J Craniomaxillofac Surg 2014 Oct 3;42(7):1352-5. Epub 2014 Apr 3.

Department of Oral and Maxillofacial Surgery/Pathology (Head: Professor Tymour Forouzanfar), VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.

The aim of this study was to assess the characteristics of patients with coronoid fractures treated in two European centres over 10 years and to briefly review the literature. This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures and surgically treated in two European centres between 2001 and 2010. During the 10 years, 1818 patients and 523 patients with maxillofacial fractures were admitted to the two centres respectively: 21 patients (16 males, 5 females) were admitted with 21 coronoid fractures and 28 associated maxillofacial fractures. A mean age of 42.1 years was observed. The fractures were mainly the result of motor vehicle accidents, followed by assaults and falls. The most frequently observed associated maxillofacial fracture was a zygomatic fracture (13 fractures). In both centres, mandibular coronoid fractures are treated unless a severe dislocation of the fractured coronoid is observed or a functional mandibular impairment is encountered. Conservative treatment can be used, together with the open reduction and internal fixation of associated fractures. The crucial point is to prevent ankylosis, which may be prevented by correct and early postoperative physiotherapy and mandibular function.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcms.2014.03.025DOI Listing
October 2014

Closed management by Ginestet hook elevator of V-shaped fractures of the zygomatic arch.

J Craniofac Surg 2014 May;25(3):1130-2

Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit University Medical Center/Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit University Medical Center/Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000000653DOI Listing
May 2014

Open surgical management of an asymptomatic giant frontal sinus osteoma.

Craniomaxillofac Trauma Reconstr 2014 Mar 8;7(1):51-4. Epub 2014 Jan 8.

Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Turin, Italy.

Osteomas are benign, slow-growing tumors that arise most frequently in the craniomaxillofacial region, and in particular in correspondence of the nose and paranasal sinuses. Osteomas may be asymptomatic for a long time until they cause deformation of the bone or compress adjacent structures. The treatment of osteomas of the frontal sinus may involve endoscopic approach or open approach. Although endoscopic treatment is the most common approach for frontal sinus osteomas, a coronal approach combined with the use of titanium mesh may still constitute a valuable option for the reconstruction of the anterior wall of the frontal sinus. This intervention is extremely important and delicate because the restoration of the integrity of the frontal sinus is crucial for its function. The purpose of this article is to present a case of frontal sinus osteoma that was treated by a coronal approach and a titanium mesh to restore frontal sinus contour.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0033-1364200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931774PMC
March 2014

Diplopia and orbital wall fractures.

J Craniofac Surg 2014 ;25(2):e183-5

From the *Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy; and †Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands.

Diplopia is a symptom that is frequently associated with orbital wall fractures. The aim of this article was to present the incidence and patterns of diplopia after orbital wall blow-out fractures in 2 European centers, Turin and Amsterdam, and to identify any correlation between this symptom and such fractures. This study is based on 2 databases that have continuously recorded data of patients hospitalized with maxillofacial fractures between 2001 and 2010. On the whole, 447 patients (334 males, 113 females) with pure blow-out orbital wall fractures were included. The most frequently involved orbital site was the floor (359 fractures), followed by medial wall (41 fractures) and lateral wall (5 fractures). At presentation, 227 patients (50.7%) had evidence of diplopia. In particular, in most patients, a diplopia in all directions was referred (78 patients). Statistically significant associations were found between diplopia on eye elevation and orbital floor fractures (P < 0.05) and between horizontal diplopia and medial wall fractures (P < 0.000005). In patients under evaluation for orbital trauma, the observation of diplopia on eye elevation and horizontal diplopia at presentation could be useful clinical indicators orbital floor and medial wall fractures, respectively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0000000000000437DOI Listing
June 2015

Review of peripheral giant cell granulomas.

J Craniofac Surg 2013 Nov;24(6):2206-8

Division of Maxillofacial Surgery, Head and Neck Department, University of Turin, Turin, Italy. Otorhinolaryngology Institute, University of Turin, Turin, Italy.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0b013e31829a8316DOI Listing
November 2013

Infraorbital nerve posttraumatic deficit and displaced zygomatic fractures: a double-center study.

J Craniofac Surg 2013 Nov;24(6):2044-6

From the *Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy; and †Departments of Oral and Maxillofacial Surgery and ‡Oral Pathology, Vrije Universiteit University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.

Typical associated signs and symptoms of displaced zygomatic fractures include lack of zygoma projection, diplopia, and sensory disturbances of the infraorbital nerve (ION). The aim of this article was to assess eventual associations between ION sensory disturbances and zygomatic fractures patterns. This study is based on 2 databases that have continuously recorded patients hospitalized with maxillofacial fractures in 2 Departments of Maxillofacial Surgery in Amsterdam, The Netherlands, and Turin, Italy between 2001 and 2010. The following data for patients surgically treated for displaced zygomatic fractures were considered: gender, age, site and severity of facial fractures, etiology, and presenting symptoms. Statistically significant associations were found between ION sensory disturbances and assaults (P = 0.007) and sport accidents (P = 0.00003), as well as between ION sensory disturbances and isolated zygomatic fractures (P = 0.000002) and between ION sensory disturbances and diplopia (P = 0.00009).The severity of injury and the absorption of middle-energy and high-energy forces by the zygomatic complex only were associated with ION sensory disturbances. The etiology and severity of the injury as well as the presence of associated symptoms should be thoroughly investigated when a zygomatic fracture is suspected.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0b013e3182a41c9dDOI Listing
November 2013

Late surgical treatment of posttraumatic mandibular deformity.

J Craniofac Surg 2013 ;24(5):e490-3

From the *Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy; and †Department of Oral and Maxillofacial Surgery, Vrije Universiteit University Medical Center/Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.

Delays in treatment may complicate the treatment of mandibular trauma, leading to a bone healing in an abnormal position and to a posttraumatic mandibular deformity such as malunion, malocclusion, and asymmetry. All these features may make delayed treatment a challenging issue. Therefore, early reduction and fixation of displaced mandibular fractures is mandatory to allow precocious healing and return to the normal function. In this article, we describe a patient treated in our unit for a diagnosed posttraumatic malocclusion after lack of primary trauma treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0b013e31829035e8DOI Listing
September 2014

A "ping-pong" fracture of the frontal sinus.

J Craniofac Surg 2013 ;24(5):1853

Division of Maxillofacial Surgery Head and Neck Department San Giovanni Battista Hospital, University of Turin Turin, Italy Otorhinolaryngology Institute University of Turin Turin, Italy.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0b013e3182902d1fDOI Listing
September 2014

Clinical outcomes of surgical management of anterior bilateral mandibular fractures.

J Craniofac Surg 2013 Jul;24(4):e387-90

Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.

Purpose: The aims of this study were to assess the clinical outcomes of patients with anterior bifocal mandibular fractures and to discuss the management of this peculiar type of trauma.

Methods: From the systematic computer-assisted database that has continuously recorded patients hospitalized with maxillofacial fractures, only patients admitted with anterior bifocal bilateral mandibular fractures between 2001 and 2011 were considered. Patients were contacted, and they were invited to volunteer for a clinical follow-up examination. Statistical analysis was performed using the Fisher exact test, and P < 0.05 was considered statistically significant.

Results: Forty dentate patients with anterior bifocal bilateral mandibular fractures (without the presence of further mandibular fractures) were included in the study. Nineteen patients with dislocated anterior segment underwent surgical intervention within 12 hours from hospital admission in the emergency department, whereas 21 patients with nondisplaced mandibular fractures were surgically treated in the elective operating room within 72 hours. Only 3 patients underwent tracheostomy. All patients underwent open reduction and internal fixation with 2.0- and 2.4-mm plates via intraoral approach, except for patients with submental or submandibular facial lacerations.

Conclusions: Anterior bifocal bilateral mandibular fractures may involve a challenging management because they can compromise the upper airway. Accurate reduction and internal fixation of these fractures have been critical to restoring form and function of the mandible. The upper airway management and securing always take first, but a prompt surgical intervention of dislocated fractures avoids upper airways impairment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0b013e318290342aDOI Listing
July 2013

Bicycle-related maxillofacial injuries: a double-center study.

Oral Surg Oral Med Oral Pathol Oral Radiol 2013 Sep 7;116(3):275-80. Epub 2013 May 7.

Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.

Objective: Bicycle-related injuries account for an important proportion of road injuries all over the world. As only few reports have focused on the characteristics of maxillofacial fractures sustained in bicycle accidents, the purpose of this study was to present and compare epidemiological data about bicycle-related maxillofacial injuries in two European centers between 2001 and 2010.

Methods: Bicycle-related facial fractures occurred in 105 patients (79 males, 26 females) in Turin, with a percentage of 5.77 among all facial fractures, and in 103 patients (55 males, 50 females) in Amsterdam, with a percentage of 19.69.

Results: The major risk groups include young people between their first to third decades. The mandible is the most frequently involved facial bone. Among mandibular injuries the most commonly involved site was the condyle.

Conclusions: Bicycle-related injuries must be considered an important etiological factor in maxillofacial fractures with typical patterns, such as a peculiar seasonal incidence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.oooo.2013.03.004DOI Listing
September 2013

Radiographic superimposition and mandibular peripheral osteoma: the importance of clinical and CT findings.

J Craniofac Surg 2013 Mar;24(2):e141-2

Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Turin, Italy.

Peripheral osteomas are benign, slow-growing osteogenic tumors that are caused by centrifugal growth of the periosteum and develop as masses attached to the cortical plates.The pathogenesis of osteomas is unclear, and embryologic, traumatic, inflammatory, metaplastic, and genetic causes have been proposed. A solitary peripheral osteoma of the jaws is uncommon.The purpose of this paper is to present a peculiar case of mandibular peripheral osteoma with a particular radiographic superimposition that stress the importance of clinical and CT findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/SCS.0b013e31827c7e87DOI Listing
March 2013