The Use of 3D Titanium Miniplates in Surgical Treatment of Patients with Condylar Fractures

Sikora, Maciej; Chęciński, Maciej; Sielski, Marcin; Chlubek, Dariusz

doi:10.3390/jcm9092923

Cited by 15 publications

(22 citation statements)

References 40 publications

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“…The current articles and academic textbooks are presenting the original RA as one of the possible methods of open surgery for a fractured uppermost portion of the mandibular condyle, i.e., the mandibular head and the upper part of the mandibular neck [ 10 , 11 ]. Lower mandibular condyle fractures cannot be visualized well with even a modified RA and require the use of other approaches [ 14 , 39 ]. Detailed classifications of the mandibular condyles’ anatomy for surgical purposes helps in assessing the possibility of using the RA for fixation and choosing the fixation method [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Variants and Modifications of the Retroauricular Approach Using in Temporomandibular Joint Surgery: A Systematic Review

Sikora

Chęciński²,

Nowak³

et al. 2021

JCM

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Introduction: The retroauricular approach (RA) has been developed in order to expose the temporomandibular joint in a way that minimizes the risk of injury to the facial nerve and masks the postoperative scar. One of its characteristics is an excellent posterolateral view of the mandibular head, which allows for the preservation of the lateral temporomandibular joint ligaments in the course of open intracapsular surgery. Aim: The aim of this study is to systematically review the currently used variants and modifications of RA. Materials and Methods: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was performed based on the PubMed and BASE search engines; furthermore the authors performed a more detailed search in the Google Scholar article database as well as a loop search within the references of papers included in the systematic review. Results: Searching medical articles databases, Google Scholar, and references yielded a total of 85 records. First the titles and abstracts were blindly screened which was followed by a full-text eligibility check resulting in eventually including and qualifying 7 articles for detailed analysis. Discussion: All known variants and modifications of RA are characterized by high safety for the facial nerve and an aesthetically hidden scar. There were no reports of auricle necrosis in the collected material. Conclusions: In this systematic review, 2 variants and 2 modifications of RA that allow for open temporomandibular joint surgery have been identified; all of them together cover a large spectrum of indications for joint surgery, including reposition and osteosynthesis of mandibular head fractures, eminoplasty, or eminectomy and treatment of some forms of ankylosis.

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Section: Discussionmentioning

confidence: 99%

Variants and Modifications of the Retroauricular Approach Using in Temporomandibular Joint Surgery: A Systematic Review

Sikora

Chęciński²,

Nowak³

et al. 2021

JCM

Self Cite

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“…Більш прогресивним методом операції остеосинтезу при переломах щелеп є використання 3D-модельованих титанових міні-пластин [40], але ці методи потребують відповідних технічного забезпечення та матеріальних ресурсів. У зв'язку з цим у клінічній практиці використовують і інші методи, наприклад, репозиції відламків з подальшою тампонадою верхньощелепної пазухи йодоформним тампоном з метою фіксації кісткових відламків, або репозиції відламків без тампонади верхньощелепної пазухи [33,41].…”

Section: обговорення результатів дослідженняunclassified

Support System of Doctor’s Decision-Making on the Choice of a Method for Treating Fractures of the Midface Area

Kochina¹,

Firsov²

2021

Ukr. ž. med. bìol. sportu

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The purpose of the study is to develop a support system of doctor’s decision-making on the choice of a method for treating fractures of the midface are. Materials and methods. The study includes the results of examination and treatment of 112 patients with fractures of the midface area, who were undergoing inpatient treatment in the Department of Head and Neck Surgery of the Municipal Noncommercial Enterprise of Kharkiv Regional Council «Regional Clinical Hospital», Kharkiv. All patients at hospitalization underwent examination according to the local protocol. The diagnosis was based on the results of cone-beam computed tomography, or multislice computed tomography. To determine the initial condition, as well as to assess the functional and cosmetic effects in the treatment process (1st, 3rd, 5th and 7th days) a visual analogue scale was used, at hospitalization we also used a visual analogue scale modified by us, which contains a point evaluation of the patient's condition for 12 signs of trauma. The Scilab computer algebra system was used to develop models for predicting the results of treatment of the midface area fractures using various methods, and a graphical application for the Windows operating system was developed for the practical use of the support system of doctor’s decision-making, in which the Sugeno fuzzy inference machine was integrated into the developed models Results and discussion. To predict the displacement of bone fragments that will remain after the surgery, the following indicators and signs were used: the nature of the fracture, the presence of paraesthesia in the infraorbital area, the presence of hemosinus; method of treatment; indicator by the modified visual analogue scale. To predict the indicator on a visual analogue scale a day after the surgery, the following indicators and signs were used: the nature of the fracture, the presence of paraesthesia in the infraorbital area, the presence of hemosinus; method of treatment, the number of plates in the case of metal osteosynthesis, the indicator by a visual analogue scale before surgery. To predict indicators by a visual analogue scale in the subsequent terms, the values of indicators by this scale in the previous terms are added to the input indicators of the model. Conclusion. As a result of the research it was found that the following can be used as the functional and cosmetic results of treatment of the midface area fracture in the development of predicting models: the amount of displacement of bone fragments, which was determined by computed tomography after surgery, and the values of indicators by a visual analogue scale after a day, 3, 5 and 7 days after surgery. The developed models for predicting functional and cosmetic results of treatment as a result of testing using indicators of 112 patients with fractures of the midface area showed an overall accuracy of 91.6%, sensitivity – 95%, specificity –96.4%.

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“…A more advanced method of osteosynthesis surgery for the jaws fractures is the use of 3D-simulated titanium mini-plates [19].…”

Section: Suggested Solution To the Problemmentioning

confidence: 99%

Results of using 3-D simulation methods in treatment of midfacial fractures

Grigorov

2021

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The article publishes the results of treatment of 27 patients with fractures of the face middle area, of which 14 used standard titanium mini-plates to reposition the fragments, and 13 – individual 3D simulated titanium mini-plates / grids. Before and after treatment, its effectiveness was assessed by the values of the displacements of bone fragments and the index of the visual-analog scale, which allows determining the functional and cosmetic effect of the surgery. It was found that the use of individual 3D simulated titanium mini-plates / grids allowed obtaining in 85 % of patients displacements not exceeding 3 mm. In 72 % of patients in whom standard titanium mini-plates were used, the displacement after surgery was 3.1–6 mm, which is significantly greater than in the group with individual modeling of structures. On the 7th day after surgery in the first group (treatment with standard mini-plates), the index on the visual-analog scale was 11 (7; 13), which was significantly (p=0.00147) less than before surgery. In the second group (treatment using individual 3D simulated titanium mini-plates / grids) the index on the visual analog scale was 4 (6; 8) points, which was significantly (Z=3.3; p=0.00098) less than before surgery. Comparison of the visual-analog scale of the first and second groups on the 7th day after surgery revealed the presence of significant (U=2.47; p=0.013) differences. The obtained results testify to the greater efficiency of individual 3D modeled titanium mini-plates / grids in comparison with standard titanium mini-plates. The object of the research: fractures of the middle area of the face. Comparison of the visual-analog scale of the first and second groups on the 7th day after surgery revealed the presence of significant (U=2.47; p=0.013) differences. Investigated problem: the comparative evaluation of the effectiveness of the middle area of the face fractures treatment using individual 3D simulated titanium mini-plates / grids and standard titanium mini-plates. The main scientific results: Optimizing the treatment of fractures of the face middle area will help to achieve good cosmetic and functional results. The area of practical use of the research results: Department of Surgical Dentistry and Maxillofacial Surgery. Innovative technological product: The proposed technique using individual 3D-simulated titanium miniplates will help to optimize the treatment of patients with traumatic fractures of the face middle area. Scope of the innovative technological product: Clinical practice.

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The Use of 3D Titanium Miniplates in Surgical Treatment of Patients with Condylar Fractures

Cited by 15 publications

References 40 publications

Variants and Modifications of the Retroauricular Approach Using in Temporomandibular Joint Surgery: A Systematic Review

Variants and Modifications of the Retroauricular Approach Using in Temporomandibular Joint Surgery: A Systematic Review

Support System of Doctor’s Decision-Making on the Choice of a Method for Treating Fractures of the Midface Area

Results of using 3-D simulation methods in treatment of midfacial fractures

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