Download PDF
Facial Plast Surg 2016; 32(01): 105-110
DOI: 10.1055/s-0036-1571350
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Retrospective 3D Radiologic Analysis of 52 Patients with Mandible Fractures

Heval Selman Özkan
1   Department of Plastic and Reconstructive Surgery, Adnan Menderes University, Aydin, Turkey
,
Saime Irkoren
1   Department of Plastic and Reconstructive Surgery, Adnan Menderes University, Aydin, Turkey
,
Yasemin Durum
2   Department of Radiology, Adnan Menderes University, Aydin, Turkey
,
Can Karaca
2   Department of Radiology, Adnan Menderes University, Aydin, Turkey
› Author Affiliations
Further Information

Publication History

Publication Date:
10 February 2016 (online)

    Permissions and Reprints

Abstract

When fractured, mandible angulates. For better preoperative evaluation, movements of fractured mandibular segments should be documented in x-, y-, and z-axes. This article quantitatively evaluates the pattern and degree of the angulation. Fifty-two patients with mandible fractures were involved in this study. After defining a three-dimensional (3D) coordination system consisting of the x-axis (the axis directed from the medial to lateral side of the skull), y-axis (directed from the inferior to superior side), and z-axis (directed from the posterior to anterior side), the degree with which the fractured mandible angulated around each of these axes was measured using 3D graphic software. The tendency of the angulation was compared between the three axes. Frequency of complications, operation times, maxilla mandibular fixation (MMF) need, and epidemiologic data were compared with the angulation results. Angulation around the x-axis was the most frequent with a 55.8% incidence, followed by a substantial margin of angulation around the y-axis with a 21.2% incidence; angulation around the z-axis was rare, with an incidence of 15.4%. Furthermore, the degree of z-axis angulation was minor compared with x- and y-axes angulations. There were statistically increased rate of complications, operation time, and MMF need in patients with more than 10 degrees of angulation in any case. Operation time and complication rates are also increased in patients with internal rotation of the proximal segment. Preoperative evaluation of mandible fracture angulation degree is useful for determining postoperative complication rates, MMF need, and operative challenge. This finding is helpful for effective performance to reposition the fractured mandible.

Keywords

3D CT - mandibular fractures - radiologic analysis
 

  • References

  • 1 Antoun JS, Lee KH. Sports-related maxillofacial fractures over an 11-year period. J Oral Maxillofac Surg 2008; 66 (3) 504-508
    CrossrefPubMedGoogle Scholar
  • 2 Yamamoto K, Matsusue Y, Murakami K , et al. Maxillofacial fractures due to work-related accidents. J Craniomaxillofac Surg 2011; 39 (3) 182-186
    CrossrefPubMedGoogle Scholar
  • 3 Assael LA. Clinical aspects of imaging in maxillofacial trauma. Radiol Clin North Am 1993; 31 (1) 209-220
    PubMedGoogle Scholar
  • 4 Levy RA, Edwards WT, Meyer JR, Rosenbaum AE. Facial trauma and 3-D reconstructive imaging: insufficiencies and correctives. AJNR Am J Neuroradiol 1992; 13 (3) 885-892
    PubMedGoogle Scholar
  • 5 Salvolini U. Traumatic injuries: imaging of facial injuries. Eur Radiol 2002; 12 (6) 1253-1261
    CrossrefPubMedGoogle Scholar
  • 6 Rhea JT, Rao PM, Novelline RA. Helical CT and three-dimensional CT of facial and orbital injury. Radiol Clin North Am 1999; 37 (3) 489-513
    CrossrefPubMedGoogle Scholar
  • 7 Ellis III E, Muniz O, Anand K. Treatment considerations for comminuted mandibular fractures. J Oral Maxillofac Surg 2003; 61 (8) 861-870
    CrossrefPubMedGoogle Scholar
  • 8 Malanchuk VO, Kopchak AV. Risk factors for development of infection in patients with mandibular fractures located in the tooth-bearing area. J Craniomaxillofac Surg 2007; 35 (1) 57-62
    CrossrefPubMedGoogle Scholar
  • 9 Mathog RH, Toma V, Clayman L, Wolf S. Nonunion of the mandible: an analysis of contributing factors. J Oral Maxillofac Surg 2000; 58 (7) 746-752 , discussion 752–753
    CrossrefPubMedGoogle Scholar
  • 10 Schuknecht B, Graetz K. Radiologic assessment of maxillofacial, mandibular, and skull base trauma. Eur Radiol 2005; 15 (3) 560-568
    CrossrefPubMedGoogle Scholar
  • 11 Yoon SJ, Wang RF, Na HJ, Palomo JM. Normal range of facial asymmetry in spherical coordinates: a CBCT study. Imaging Sci Dent 2013; 43 (1) 31-36
    CrossrefPubMedGoogle Scholar
  • 12 Yoon SJ, Wang RF, Ryu SY , et al. Use of spherical coordinates to evaluate three-dimensional facial changes after orthognathic surgery. Imaging Sci Dent 2014; 44 (1) 15-20
    CrossrefPubMedGoogle Scholar
  • 13 Yoon SJ, Wang RF, Hwang HS, Kang BC, Lee JS, Palomo JM. Application of spherical coordinate system to facial asymmetry analysis in mandibular prognathism patients. Imaging Sci Dent 2011; 41 (3) 95-100
    CrossrefPubMedGoogle Scholar
  • 14 Moreno JC, Fernández A, Ortiz JA, Montalvo JJ. Complication rates associated with different treatments for mandibular fractures. J Oral Maxillofac Surg 2000; 58 (3) 273-280 , discussion 280–281
    CrossrefPubMedGoogle Scholar
  • 15 Iida S, Kogo M, Sugiura T, Mima T, Matsuya T. Retrospective analysis of 1502 patients with facial fractures. Int J Oral Maxillofac Surg 2001; 30 (4) 286-290
    CrossrefPubMedGoogle Scholar
  • 16 Al Ahmed HE, Jaber MA, Abu Fanas SH, Karas M. The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: a review of 230 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98 (2) 166-170
    CrossrefPubMedGoogle Scholar
  • 17 Czerwinski M, Parker WL, Beckman L, Williams HB. Rapid intraoperative zygoma fracture imaging. Plast Reconstr Surg 2009; 124 (3) 888-898
    CrossrefPubMedGoogle Scholar