Nutritional intervention during maxillomandibular fixation of jaw fractures prevents weight loss and improves quality of life

Popat, Sandip; Rattan, Vidya; Rai, Sachin; Jolly, Satnam Singh; Malhotra, Savita

doi:10.1016/j.bjoms.2020.10.009

Cited by 9 publications

(3 citation statements)

References 24 publications

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“…The sample size calculation was conducted via an online statistical calculator (Statulator, https://statulator.com/) based on a study by Popat, S. P., Rattan, V., Rai, S., Jolly, S. S., & Malhotra, S. (2021) 14 The Calculator for Comparing Two Independent Means was accessed on November 28, 2021, at http://statulator.com/SampleSize/ss2M.html. Assuming a pooled standard deviation of 6 units, the study required a sample size of 14 for each group (total sample size of 28, assuming equal group sizes) to achieve a power of 80% and a level of signi cance of 5% (two-sided) for detecting a true difference in means between the test and the reference group of 6.63 (i.e., 61.33-54.70) units.…”

Section: Resultsmentioning

confidence: 99%

Effects of oral nutritional supplement on postoperative orthognathic surgery patients’ nutritional status: a randomised clinical trial

Prachasartta,

Siriwatana,

Trachoo

et al. 2024

Preprint

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Background Orthognathic surgery limits oral intake and increases metabolic demand, leading to decreased muscle mass. To mitigate these effects, incorporating oral nutritional supplements (ONS) into a nutritional therapy plan is recommended. However, nutrition therapy has not received much attention in orthognathic surgery. This study aimed to assess the effect of ONS on postoperative orthognathic surgery patients’ nutritional status. Methods A 12-week randomised controlled trial was conducted between June and December 2022 at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok. Patients were included if they were 18 years of age or older, underwent orthognathic surgery involving at least one jaw, and had no metabolic-related diseases, milk or soy allergies, or galactosemia. Patients who underwent segmental procedures or genioplasty alone were excluded. The predictor variable was ONS. Subjects were randomly assigned by the block randomisation method into two groups: 1) subjects who received ONS, and 2) subjects who did not receive ONS. The primary outcome variable was nutritional status, which was measured using anthropometric, biomarker, and muscle strength assessments at 5 time points: a day before surgery (T0), the day of discharge (T1), 2 weeks (T2), 4 weeks (T3), and 12 weeks postoperatively (T4). Covariates were subjects’ demographics, oral health-related quality of life, and dietary record assessment. The T-test, or Mann-Whitney U test, was used to compare the mean difference of continuous data, where appropriate. The differences were considered statistically significant when the p-value was less than 0.05. Results A total of 36 subjects were included in the study. Subjects receiving either nutritional counselling alone or both nutritional counselling and ONS experienced postoperative weight and muscle mass loss, with no significant differences observed across all nutritional status parameters after the 12-week postoperative mark. Conclusion These results suggest the need for more personalised and intensive nutrition therapy plans to reduce the negative impact of muscle mass loss and the associated risk of postoperative infection in orthognathic surgery patients. Trial registration: This study has been registered with the Thai Clinical Trial Registration (https://www.thaiclinicaltrials.org/), with the registration number TCTR20220624006, registered on June 24, 2022.

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Section: Resultsmentioning

confidence: 99%

Effects of oral nutritional supplement on postoperative orthognathic surgery patients’ nutritional status: a randomised clinical trial

Prachasartta,

Siriwatana,

Trachoo

et al. 2024

Preprint

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“…Popat et al conducted a thorough analysis of previous studies that specifically investigated the comparative effectiveness of open and closed treatment methods for condylar fractures, with the objective of ascertaining the treatment approach that yields superior outcomes. However, the findings of the research yielded inconclusive outcomes regarding the most effective method, whether it be open or closed therapy, for managing mandibular condylar fractures 29 .…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Clinical Outcomes in Patients of Mandibular Condyles Fractures Treated with Open Versus Close Reduction

Abbas,

Nazir,

Khan

et al. 2023

PJMHS

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Aim: The absence of a widely acknowledged and conclusive therapy for condylar fractures is a matter of contemporary debate and contention, with the issue of whether surgical or conservative approaches are better suitable for managing such fractures being unresolved. This study investigates several methodologies pertaining to the conservative, closed, and open surgical interventions for the treatment of condylar fractures. The standardization of fracture classification systems and treatment techniques is necessary to provide a clear and optimum strategy for individual individuals and their respective fractures. Objectives: The objectives of the study are to compare clinical outcomes in patients of mandibular condyles fractures treated with open versus close reduction. Method: A total of 84 individuals diagnosed with subcondylar fractures of the mandible were assessed. All fractures seen in the study exhibited displacement, with either angulation ranging from 10° to 35° or a reduction in length of the ascending ramus by more than 2 mm. A comprehensive assessment, including both clinical and radiographic examination, was conducted at the 6-month mark after the occurrence of the trauma. The clinical criteria assessed in this study included mouth opening, temporomandibular joint (TMJ) discomfort, mandibular deviation, malocclusion, facial damage, and scar formation. Results: The findings indicated a statistically significant difference between the two groups, with a p-value of less than 0.05. The findings suggest that open reduction was found to be more efficacious than closed reduction in enhancing mouth opening, mandibular deviation, TMJ discomfort, and malocclusion. Conversely, closed reduction was shown to be more beneficial than open reduction. Conclusion: The study findings indicate that the open treatment approach yields superior progress compared to closed techniques, and these differences are statistically significant. Patients who had open reduction demonstrated considerably superior results in all functional measures, with the exception of facial nerve damage and scar formation, when compared to those who underwent closed reduction. Keyword: Mandibular fracture, open reduction, closed reduction, clinical outcome

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“…1 It helps in assisting the treatment of maxillofacial trauma by restoring the patient's premorbid occlusion by closed reduction as a sole treatment modality or as an adjunct in open reduction and internal fixation. 2,3 It also plays an important role in orthognathic surgery by restoring maxillomandibular relation during the single jaw or bi-jaw surgery. 4 By securing them into the best possible pre-trauma occlusion, the fracture will temporarily be both reduced to the correct position and stabilized.…”

Section: Introductionmentioning

confidence: 99%

To Determine Mean Change In Weight Of Patients Undergoing Maxillomandibular Fixation

Mushtaq,

Shuja,

Ahmed

et al. 2023

JRMC

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Objective: Optimum management of patient needs is the most important step for the restoration of form and function. Maxillomandibular fixation is one of the treatment modalities used very frequently in maxillofacial surgery. This study aims to determine the mean change in weight in patients undergoing Maxillomandibular Fixation. Methods: This observational cross-sectional study was conducted at the Department of Oral and Maxillofacial Surgery Foundation University Medical College from 27th April 2018 to 22nd January 2019. This study included patients male and female, who presented with maxillofacial trauma, orthognathic surgery and procedures in which MMF ( Maxillomandibular fixation ) was indicated were included in this study. Pre-operative weight was measured in kilograms with an analogue weight machine and designated as W1. Patients were advised to a liquid diet and kept on follow-up. After four weeks of MMF again weight of the patient was measured and designated as W2. Follow-up was done through the patient's contact number. Results: In this study, the mean weight of patients preoperatively was 59.46±12.23 Kg. The postoperative mean weight of patients was 57.81±11.58 Kg. A decrease of 1.65 Kg was seen in the patient’s weight postoperatively. No significant difference was seen for weight change in patients postoperatively with age, gender, educational status, occupational status, socioeconomic status and an indication of MMF. Conclusion: Results of this study showed weight loss in patients who underwent maxillomandibular fixation. This factor should be considered during the perioperative period to prevent postoperative complications, postoperative weight loss, and malnutrition of patients undergoing maxillomandibular surgery and reflect the need for guidance on diet postoperatively, mainly directed to frequency of feeding and high protein liquid diet and nutritional supplements. Keywords: Body mass index, Facial trauma, Maxillomandibular Fixation, Mandibular fracture, Open reduction internal fixation, Orthognathic surgery, Weight loss.

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Nutritional intervention during maxillomandibular fixation of jaw fractures prevents weight loss and improves quality of life

Cited by 9 publications

References 24 publications

Effects of oral nutritional supplement on postoperative orthognathic surgery patients’ nutritional status: a randomised clinical trial

Effects of oral nutritional supplement on postoperative orthognathic surgery patients’ nutritional status: a randomised clinical trial

A Comparison of Clinical Outcomes in Patients of Mandibular Condyles Fractures Treated with Open Versus Close Reduction

To Determine Mean Change In Weight Of Patients Undergoing Maxillomandibular Fixation

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