Avelino Sabrina Gardiano, de Assis Santos Vinícius Paes, Palmieri Celso F, Luz João Gualberto C
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil.
Department of Oral and Maxillofacial Surgery, Hospital M. Dr. Arthur R. de Saboya, São Paulo, Brazil.
Dent Traumatol. 2023 Feb;39(1):25-30. doi: 10.1111/edt.12792. Epub 2022 Oct 10.
BACKGROUND/AIMS: The ideal management of teeth in the line of mandibular fractures is unclear and controversial. The aim of this study was to analyze the characteristics and management of teeth in the line of mandibular fractures treated with open reduction and internal fixation.
Medical records of patients with mandibular fractures in the symphysis, body and angle regions seen between July 2019 and January 2021 were evaluated. Personal data, etiology, location of fractures, characteristics of the teeth involved in the fracture lines and management were collected. The relationship between the fracture lines and the periodontium was classified according to Kamboozia & Punnia-Moorthy. Fractures were divided into two groups according to the management of the tooth in the fracture line: removal and retention. The likelihood ratio test was used (p < .050).
During the study period, 52 patients with mandibular fractures were seen, of which 42 patients (83.3% men) with a mean age of 29.6 years and 54 fractures were included. The most frequent location was the angle of the mandible (41.3%) (p < .001). The removal group represented 35.2% of the fractures, and the retention group represented 64.8%. The most frequently removed tooth was the third molar (p < .001), and the most frequent classification of dental involvement in the fracture line was type II (p = .047). There was no correlation between age, gender, or etiology and the management of the teeth involved.
The retention of teeth in the fracture line predominated, and the third molar in angle fractures was the most often removed tooth when the fracture line followed the root surface but did not cross the apical region, probably due to the greater frequency of this type of relationship between the fractures and the periodontium.
背景/目的:下颌骨骨折线上牙齿的理想处理方式尚不清楚且存在争议。本研究的目的是分析采用切开复位内固定治疗的下颌骨骨折线上牙齿的特征及处理方式。
对2019年7月至2021年1月期间收治的下颌骨颏部、体部及角部骨折患者的病历进行评估。收集患者的个人资料、病因、骨折部位、骨折线累及牙齿的特征及处理方式。根据Kamboozia和Punnia-Moorthy的方法对骨折线与牙周组织的关系进行分类。根据骨折线上牙齿的处理方式将骨折分为两组:拔除组和保留组。采用似然比检验(p < 0.050)。
研究期间共收治52例下颌骨骨折患者,其中42例(83.3%为男性)纳入研究,平均年龄29.6岁,共54处骨折。最常见的骨折部位是下颌角(41.3%)(p < 0.001)。拔除组占骨折的35.2%,保留组占64.8%。最常拔除的牙齿是第三磨牙(p < 0.001),骨折线累及牙齿最常见的分类为Ⅱ型(p = 0.047)。年龄、性别或病因与骨折线上牙齿的处理方式之间无相关性。
骨折线上牙齿保留为主,当骨折线沿牙根表面但未穿过根尖区时,角部骨折中的第三磨牙是最常拔除的牙齿,这可能是由于这种骨折与牙周组织关系的类型更为常见。