scholarly journals Exposure to Ti4Al4V Titanium Alloy Leads to Redox Abnormalities, Oxidative Stress, and Oxidative Damage in Patients Treated for Mandible Fractures

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Jan Borys ◽  
Mateusz Maciejczyk ◽  
Bożena Antonowicz ◽  
Adam Krętowski ◽  
Danuta Waszkiel ◽  
...  
Keyword(s):  
Titanium Alloy ◽  
Oxidative Damage ◽  
Activity Concentration ◽  
Maxillofacial Surgery ◽  
Redox Balance ◽  
Passive Layer ◽  
Oxidative Modification ◽  
Mandibular Fractures ◽  
Mandible Fractures ◽  
Increased Activity

Due to the high biotolerance, favourable mechanical properties, and osseointegration ability, titanium is the basic biomaterial used in maxillofacial surgery. The passive layer of titanium dioxide on the surface of the implant effectively provides anticorrosive properties, but it can be damaged, resulting in the release of titanium ions to the surrounding tissues. The aim of our work was to evaluate the influence of Ti6Al4V titanium alloy on redox balance and oxidative damage in the periosteum surrounding the titanium miniplates and screws as well as in plasma and erythrocytes of patients with mandibular fractures. The study included 31 previously implanted patients (aged 21–29) treated for mandibular fractures and 31 healthy controls. We have demonstrated increased activity/concentration of antioxidants both in the mandibular periosteum and plasma/erythrocytes of patients with titanium mandibular fixations. However, increased concentrations of the products of oxidative protein and lipid modifications were only observed in the periosteum of the study group patients. The correlation between the products of oxidative modification of the mandible and antioxidants in plasma/erythrocytes suggests a relationship between the increase of oxidative damage at the implantation site and central redox disorders in patients with titanium miniplates and screws.

Comparison of Preauricular Approach Versus Retromandibular Approach in Management of Condylar Fractures

2021 ◽  
Vol 15 (8) ◽  
pp. 2137-2140
Author(s):  
Ashfaq ur Rahim ◽  
Sadiq Ali ◽  
Muhammad Nauman ◽  
Tannaza Qayyum ◽  
Abdullah Khan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Maxillofacial Surgery ◽  
Conventional Technique ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
Surgical Methods ◽  
Mandible Fractures ◽  
Preauricular Approach ◽  
Condyle Fracture ◽  
Condylar Fractures

Objectives: Surgical treatment of patients with multiple mandibular fractures involving condylar segments may be a difficult proposition for a maxillofacial surgeon. These fractures can be double or triple fractures of the lower mandible and can also be associated with other fractures of the face. While many authors have suggested that the conventional approach to reducing and stabilizing a mandibular symphysis / para-symphysis fracture is appropriate before addressing a fractured condyle, there is another school of thought that suggests that the condylar segment should be reduced and repaired first. This article aims to review the results of operations where the reduction and fixation of a fractured condyle is performed prior to other associated mandible fractures, and to explore the effectiveness of various surgical methods including preauricular and retromandibular proposed in this case. Place and Duration: In the Oral and Maxillofacial surgery department of Faryal Dental College, Lahore for two-years duration from Jan 2018 to Jan 2020. Material and methods: The study included 60 surgically treated patients with multiple mandible fractures (double / triple), including the condyle component. For treatment of the fractured condylar segments, the preauricular and retromandibular (anterior parotid-transmasseteric) approach was used. Results: Condyle fracture was the first segment to be managed during sequencing of surgical treatment, regardless of the method used. First, good reduction and stabilization have been achieved with limited complications in treating a condyle fracture. Conclusion: While it is the surgeon's prerogative to sort multiple mandible fractures, addressing the condylar segment first provides the operator with a viable alternative to the conventional technique. Key words: condylar fractures, multiple mandibular fractures, preauricular approach, retromandibular approach

scholarly journals 1114 Getting it Right First Time: An Audit of Length of Hospital Stay for Mandibular Fractures

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
F Mitchell ◽  
J Parmar
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Maxillofacial Surgery ◽  
Length Of Hospital Stay ◽  
National Standard ◽  
Oral And Maxillofacial Surgery ◽  
Service Improvement ◽  
Mandibular Fractures ◽  
Average Length Of Stay ◽  
Mandible Fractures

Abstract Introduction GIRFT is a Department of Health programme, created to improve efficiency by providing data that gives departments a national standard to encourage reflection and service-improvement. The 2016 document in Oral and Maxillofacial Surgery, suggests the national average length of stay for isolated mandible fractures was 2 days, 1 day pre-operatively and 1 day post-operatively. This Audit aimed to investigate if all admissions in our trust met this standard, as a short stay reduces costs and improves patient experience. Method Data was collected for all isolated mandibular fracture admissions between January – September 2019, with 89 patients identified. Date of admission, surgery and discharge was recorded which allowed calculation of pre-operative, post-operative, and total stay. Results 78% of patients had surgery within 24 hours of admission. Admissions on a Saturday were most often delayed, with a mean pre-operative stay of 1.60 days and total stay of 2.55 days. Commonly the reason for delay was not recorded, or due to lack of theatre space. 92% of patients were discharged within 24 hours post-operatively. The average length of stay met the 2-day standard, with Monday admissions having the shortest average stay of 1.45 days. Conclusions Whilst the majority of patients are treated and discharged within 2 days, improvements and future audit would assist to get closer to the 100% target. Saturday saw the highest number of admissions, which also had the longest average length of stay. A dedicated weekend trauma list would reduce wait times but may be limited by staffing and theatre space.

scholarly journals Evaluation of in-house, haptic assisted surgical planning for virtual reduction of complex mandibular fractures

2021 ◽  
Author(s):  
Johanna Nilsson ◽  
Fredrik Nysjö ◽  
Ingela Nyström ◽  
Johan Kämpe ◽  
Andreas Thor
Keyword(s):  
Computed Tomography ◽  
Surgical Planning ◽  
Maxillofacial Surgery ◽  
Three Dimensional ◽  
Planning System ◽  
Virtual Surgery ◽  
Mandibular Fractures ◽  
Surgery Planning ◽  
Anatomic Reduction ◽  
Mandible Fractures

Abstract Purpose The management of complex mandible fractures, i.e. severely comminuted or fractures of edentulous/atrophic mandibles, can be challenging. This is due to the three-dimensional loss of bone, which limits the possibility for accurate anatomic reduction. Virtual surgery planning (VSP) can provide improved accuracy and shorter operating times, but is often not employed for trauma cases because of time constraints and complex user interfaces limited to two-dimensional interaction with three-dimensional data. Methods In this study, we evaluate the accuracy, precision, and time efficiency of the haptic assisted surgery planning system (HASP), an in-house VSP system that supports stereo graphics, six degrees-of-freedom input, and haptics to improve the surgical planning. Three operators performed planning in HASP on computed tomography (CT) and cone beam computed tomography (CBCT) images of a plastic skull model and on twelve retrospective cases with complex mandible fractures. Results The results show an accuracy and reproducibility of less than 2 mm when using HASP for virtual fracture reduction, with an average planning time of 15 min including time for segmentation in the software BoneSplit. Conclusion This study presents an in-house haptic assisted planning tool for cranio-maxillofacial surgery with high usability that can be used for preoperative planning and evaluation of complex mandible fractures.

scholarly journals Comparative evaluation of biting force in 2mm locking plates with 2mm miniplates in the treatment of mandible fractures: A clinical study

2021 ◽  
Vol 7 (3) ◽  
pp. 135-144
Author(s):  
V Shakuntala Soujanya ◽  
Abhishek Reddy ◽  
K Kranthi ◽  
Dilip Pantham ◽  
Durga Keerthi P
Keyword(s):  
Stainless Steel ◽  
Maxillofacial Surgery ◽  
Bite Force ◽  
Mandibular Fractures ◽  
Locking Plates ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mandible Fractures ◽  
Molar Region

1. To compare efficacy of 2mm locking plates with 2mm miniplates in the fixation of mandible fractures and 2. To evaluate and compare the biomechanical function by measuring the bite force at 1st week, 3rd week, 6th week and 3rd month postoperatively in 20 patients divided equally into two study groups.A prospective randomized study was carried out at Department of Oral and Maxillofacial Surgery, Meghna Institute of Dental Sciences, Nizamabad from 2019 to 2021 to treat consecutive mandibular fractures where patients were randomly divided into two groups each composed of 10 patients where Group A were treated with single 4 holed stainless-steel locking miniplates and Group B with two 4 holed stainless steel conventional mini plates both maintaining a gap of 2.0 mm system. Later assessment was done using bite force recording postoperatively at 1st week, 3rd week, 6th week and 3rd month and with the associated complications like Swelling, Infection, Paresthesia, Mobility between fracture fragments and Hardware failure.When the mean bite force values in right molar region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A when compared to group B at 1st week and 3rd week (P<0.05). But no statistically significant differences were observed at 6th week and 3rd month (P>0.05).When the mean bite force values in the central incisor region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A compared to group B at 1st week and 3rd week (P<0.05). But no statistically significant differences were observed at 6th week and 3rd month (P>0.05).When the mean bite force values in left molar region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A when compared group B at 3rd week (P<0.05). But no statistically significant differences were observed at 1st week, 6th week and 3rd month (P>0.05).The study signifies that both the fixation systems were able to provide stability to fracture segments, but locking plate system has provided better stability when compared to miniplates system, hence recommending for more elaborative studies to arrive at definitive conclusion.

scholarly journals Pathologic Fractures in Bisphosphonate-Related Osteonecrosis of the Jaw—Review of the Literature and Review of Our Own Cases

2013 ◽  
Vol 6 (3) ◽  
pp. 147-154 ◽  
Author(s):  
Sven Otto ◽  
Christoph Pautke ◽  
Sigurd Hafner ◽  
Ronny Hesse ◽  
Lea Franziska Reichardt ◽  
...  
Keyword(s):  
Case Reports ◽  
Treatment Options ◽  
Maxillofacial Surgery ◽  
Case Series ◽  
Pathologic Fracture ◽  
Osteonecrosis Of The Jaw ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
Pathologic Fractures ◽  
Mandible Fractures

Background Bisphosphonates are powerful drugs used for the management of osteoporosis and metastatic bone disease to avoid skeletal-related complications. Side effects are rare but potentially serious such as the bisphosphonate-related osteonecrosis of the jaws (BRONJ). BRONJ impairs the quality of life and can even lead to pathologic fractures of the mandible. Management of BRONJ is difficult per se. If complicated with pathologic mandibular fractures in advanced stages, the treatment options are controversially discussed. This review delineates the epidemiology and pathogenesis of BRONJ to put the various modalities for the treatment of pathologic mandible fractures into perspective. Methods Various case reports and case series in the literature were reviewed. Cases were reviewed of patients suffering from pathologic fracture due to bisphosphonate-related osteonecrosis of the jaw treated in the Department of Oral and Maxillofacial Surgery (Ludwig-Maximilians-University of Munich) from 2003 to 2010. Of 140 patients suffering from BRONJ, four were identified with pathologic fracture of the mandible. Results Management of pathologic mandibular fractures in patients suffering from BRONJ is an unsolved issue. At present there is a paucity of information to establish reliable therapy guidelines. The published strategies range from conservative treatment to major bone resections with or without internal or external fixation and with or without autogenous reconstruction. There is no evidence for the superiority of a single therapeutic mode, however. Conclusion Further understanding of BRONJ is mandatory to establish a sound rationale for the treatment of associated mandibular fractures.

scholarly journals Antioxidant Defense, Oxidative Modification, and Salivary Gland Function in an Early Phase of Cerulein Pancreatitis

2019 ◽  
Vol 2019 ◽  
pp. 1-14 ◽  
Author(s):  
Mateusz Maciejczyk ◽  
Anna Skutnik-Radziszewska ◽  
Izabela Zieniewska ◽  
Jan Matczuk ◽  
Emilia Domel ◽  
...  
Keyword(s):  
Free Radicals ◽  
Oxidative Damage ◽  
Salivary Glands ◽  
Morphological Changes ◽  
Redox Balance ◽  
Oxidative Modification ◽  
Total Protein Content ◽  
Submandibular Glands ◽  
Male Wistar Rats ◽  
Gland Function

Acute pancreatitis (AP) is a multifactorial disease characterized by necroinflammatory changes of the pancreas. Our study is the first study which evaluated the relationship between the free radical production, enzymatic and nonenzymatic antioxidants, oxidative damage, and secretory function of the salivary glands of AP rats. Male Wistar rats were divided equally into 2 groups: control (n=9) and AP (n=9). AP was induced by intraperitoneal injection with cerulein and confirmed by higher serum amylase and lipase. We have demonstrated that the superoxide dismutase and glutathione reductase activities, as well as reduced glutathione concentration, were significantly decreased in both the parotid and submandibular glands of AP rats as compared to the control rats. The production of free radicals evidenced as dichlorodihydrofluorescein assay and the activity of NADPH oxidase and xanthine oxidase and IL-1β concentration were significantly higher in the parotid and submandibular glands of AP rats compared to the controls. In AP rats, we also showed a statistical increase in oxidation modification products (advanced glycation end products and advanced oxidation protein products), salivary amylase activity, and significant decrease in the total protein content. However, we did not show apoptosis and any morphological changes in the histological examination of the salivary glands of AP rats. To sum up, cerulein-induced AP intensifies production of oxygen free radicals, impairs the redox balance of the salivary glands, and is responsible for higher oxidative damage to these glands. Interestingly, oxidative modification of proteins and dysfunction of the antioxidant barrier are more pronounced in the submandibular glands of AP rats.

scholarly journals Treatment of Mandible Fractures Using a Miniplate System: A Retrospective Analysis

2020 ◽  
Vol 9 (9) ◽  
pp. 2922
Author(s):  
Lauren Bohner ◽  
Fabian Beiglböck ◽  
Stephanie Schwipper ◽  
Rômulo Maciel Lustosa ◽  
Carla Pieirna Marino Segura ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Three Dimensional ◽  
Fracture Site ◽  
University Hospital ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
Biomechanical Behavior ◽  
Initial Stability ◽  
Tension And Compression ◽  
Mandible Fractures

Three-dimensional (3D) mini plate systems are used in the treatment of mandibular fractures. The system is advantageous in comparison to conventional plates due to the stabilization of tension and compression areas, improved initial stability, and biomechanical behavior. The aim of this retrospective study was to evaluate the use of a 3D miniplate system for the treatment of patients with mandibular fractures. Patients with mandibular fractures treated with a 3D plate system at the Department of Oral and Maxillofacial Surgery, University Hospital Münster, during a period of 5 years, were included in this study. Mandibular fracture conditions and minor and major post-operative complications were reported. In total, 336 patients and 391 mandibular fractures were assessed. The most common fracture site was anterior mandible, and 155 cases involved a tooth-bearing area. Minor complications were seen in 8.03% of cases, whereas only 1.49% of patients suffered from major complications. The treatment of mandible fractures using 3D miniplates resulted in fracture reduction with a low complication rate.

Mandibular Bone Fractures in elderly patients with reference to etiology of trauma

2021 ◽  
Vol 15 (8) ◽  
pp. 1920-1922
Author(s):  
Nabeela Riaz ◽  
Samreen Younas ◽  
Ijaz Ur Rehman ◽  
Ahmad Abdul Haseeb ◽  
Saba Hanif ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Bone Fractures ◽  
Financial Burden ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
Mandibular Bone ◽  
Mandibular Injuries

Aim: to explore the mandibular bone fractures in elderly patients with reference to etiology of trauma. Methodology: This was a descriptive study conducted in the department of Oral and Maxillofacial Surgery KEMU/ Mayo Hospital Lahore. Elderly patients (age 60-100years) with mandibular bone fractures. Results: Aetiology of trauma leading to mandibular fractures was as follows; there were 79(65.83%) cases of RTA, 32(26.66%) falls, 4(3.33%) assaults and there were only 3(2.5%) cases of industrial injury. Conclusion: To conclude, this study depicts that road traffic accidents were the predominant cause of injury in the studied age group. Elderly patients need more care and attention, especially after traumatic incidents and lead to financial burden in hospitals Keywords: Maxillofacial trauma, Elderly population, Mandibular injuries, Elderly fractures

Abstract 177: Promotion Of Nitroso-redox Balance By Beta 3 Adrenoceptor Agonism: Therapeutic Implications For Cardiovascular Complications Of Diabetes

2014 ◽  
Vol 115 (suppl_1) ◽  
Author(s):  
Keyvan Karimi Galougahi ◽  
Chia-chi Liu ◽  
Alvaro Garcia ◽  
Natasha A Fry ◽  
Clare L Hawkins ◽  
...  
Keyword(s):  
Nadph Oxidase ◽  
Cardiac Myocytes ◽  
Vascular Dysfunction ◽  
Pump Current ◽  
Redox Balance ◽  
Cardiovascular Complications ◽  
Oxidative Modification ◽  
Oxidation Products ◽  
Therapeutic Implications ◽  
Endothelial Nitric Oxide

Rationale: Disrupted balance between NO and O2.- is central in pathobiology of diabetes-induced cardiomyopathy and vascular dysfunction. We examined if stimulation of β3 adrenergic receptors (β3 ARs), coupled to endothelial nitric oxide synthase (eNOS) activation, would re-establish NO/O2.- balance, relieve oxidative inhibition of key caveolar proteins and protect against diabetes-induced cardiovascular dysfunction. Methods/Results: A hyperglycemic, hyperinsulinemic state was established in male White New Zealand rabbits by infusion of the insulin receptor antagonist S961 (12 μg/kg/h). Diabetes induced NADPH oxidase-dependent glutathionylation (GSS-) of the caveolar proteins Na+-K+ pump’s β1 subunit and eNOS in cardiac myocytes and aorta, an oxidative modification that inhibits the pump and uncouples eNOS. Consistent with this, diabetes was associated with reduced electrogenic Na+-K+ pump current in voltage-clamped cardiac myocytes and impaired endothelium-dependent vasorelaxation. Selective β3 AR agonist CL316243 (CL, 40 μg/kg/h) restored NO levels analysed by spin-trapping of NO-Fe(DETC)2 complexes; decreased diabetes-induced elevation in O2.- measured by HPLC analysis of dihydroethidium oxidation products, improved endothelium-dependent vasorelaxation, and restored the Na+-K+ pump function in cardiac myocytes. These effects were mediated by CL abolishing diabetes-induced increase in eNOS-GSS and β1-GSS through a decrease in forward reaction rate for glutathionylation by suppressing diabetes-induced NADPH oxidase activation, which was further amplified by promotion of de-glutathionylation via enhancement in association of glutaredoxine-1, the enzyme catalysing de-glutathionylation, with eNOS and Na+-K+ pump. Conclusion: β3 AR activation re-established nitroso-redox balance and relieved oxidative inhibition of key caveolar proteins in diabetes. β3 AR agonists are promising in treatment of diabetes-induced cardiovascular complications.

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