No abstract

Statement of the Problem: Using plate and screws as the conventional bone fixation method in maxillofacial fractures leads to many complications as plate exposure, infection or unpleasant feeling on touching.  Finding a substitute fixation method has been a far desire for many years. Purpose: This study compared the new bone formation using an experimental bone adhesive containing a functional monomer (benzophenone tetracarboxylic di-methacrylate, BTDMA) and the conventional plate and screw in fractured mandibles of rabbit. Materials and Method: This is an experimental animal study. The artificial fractures were induced at the mandibular angles of three male New Zealand rabbits. Screw and plate were used as control and titanium mesh with the resin-based bone adhesive containing 15 wt. % BTDMA monomer were applied as treatment. The mandible radiography were obtained and the density of the fracture line was compared to the control. The newly formed bone was assessed by a microscope. Results: The results obtained from the MTT cytotoxicity assay showed that 70% of cells were able to grow in the presence of the adhesive. The radiographic density of mesh-adhesive specimens was 119.88±76.29, while conventional plate specimens' density was 120.38±73.89. The average new bone formation score in the mesh specimens and plate specimens was 3.67±4.62 and 7±4.36, respectively. There was no significant difference between the two groups. The application of bone adhesive containing 15% BTDMA monomer in a group of the rabbits showed lamellar bone formation. Conclusion: Using bone adhesives containing BTDMA could lead to a new bone formation with high density in the case of adequate bonding to the fractured area.

No abstract

We present 3 cases of Panfacial fractures through which we try to emphasize two important sequencing rules: "Reference point"(the most intact area to determine the starting point for fixation) and the "Confirming points" (the points which should be checked out to confirm the exact position & orientation).

A therapeutic challenge to maxillofacial surgeons is management of panfacial fractures, especially when treating multiple comminuted bone fractures. One of the most important goals in these fractures is achieve and stablish a correct occlusal relationship of the mandibular-maxillary unit in parallel with the proper positioning of the jaws with the skull base and other facial units. Also, it is important to prevent long-term sequelae such as facial asymmetry, enophthalmos, and mal- occlusion that could be caused by inadequate correction. To achieve all these goals some usual guides of management are proposed as follow: “Bottom to up”, “Top to down”, “outside to inside,” or “inside to outside”. We present 3 cases of Panfacial fracture and the proposed methods were based on different sequences of management with introducing “reference point” as the most intact area to determine the management concept & “confirming point” as the areas that should be reduced and fixed completely. These points act as an orientation aid during surgery and aid to successfully restore the entire face contour and maxillomandibular occlusion and also to improves surgical procedure.