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PubMed2003

Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries.

INTRODUCTION: Cranio-maxillofacial trauma management requires pertinent documentation. Using a large computerized database, injury surveillance and research data describe the whole spectrum of injuries. The goal of this study was to assess the effect of the five main causes of accidents resulting in facial injury on the severity of cranio-maxillofacial trauma. PATIENTS AND METHODS: During a period of 10 years (1991-2000) 9,543 patients were admitted to the Department of Oral and Maxillofacial Surgery, University Hospital of Innsbruck with cranio-maxillofacial trauma. Data of patients were prospectively recorded including cause of injury, age and gender, type of injury, injury mechanisms, location and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures and concomitant injuries. Statistical analyses performed included descriptive analysis, chi square test, Fisher's exact test, and Mann-Whitney's U test. This was followed by logistic regression analyses for the three injury types to determine the impact of the five main causes on the type of injury at different ages in facial trauma patients. RESULTS: Five major categories/mechanisms of injury existed: in 3,613 (38%) cases it was activity of daily life, in 2991 (31%) sports, 1170 (12%) violence, in 1,116 (12%) traffic accidents, in 504 (5%) work accidents and in 149 (2%) other causes. A total of 3,578 patients (37.5%) had 7,061 facial bone fractures, 4,763 patients (49.9%) suffered from 6,237 dentoalveolar, and 5,968 patients (62.5%) from 7,769 soft tissue injuries. Gender distribution showed an overall male-to-female ratio of 2.1 to 1 and the mean age was 25.8+/-19.9 years; but both varied greatly depending on the injury mechanism (facial bone fractures: 35.4+/-19.5 years, higher risk for males; soft tissue injuries: 28.7+/-20.5, no gender preference; dentoalveolar trauma: 18+/-15.6, elevated risk for females). For patients sustaining facial trauma, logistic regression analyses revealed increased risks for facial bone fractures (225%), soft tissue lesions (58%) in patients involved in traffic accidents, and dental trauma (49%) during activities of daily life and play accidents. When compared with other causes, the probability of suffering soft tissue injuries and dental trauma, but not facial bone fractures, is higher in sports-related accidents, 12 and 16%, respectively. CONCLUSION: This study differentiated between injury mechanisms in cranio-maxillofacial trauma. The specially trained surgeons treating cranio-maxillofacial trauma are the primary source of information for the public and legislators on implementing preventive measures for high-risk activities. In facial trauma, older persons are prone to bone fractures (increase of 4.4%/year of age) and soft tissue injuries (increase of 2%/year of age) while younger persons are more susceptible to dentoalveolar trauma (decrease of 4.5%/year of age).

Accidents↗
PubMed1998

[Athletic injuries in mouth, jaw and facial surgery].

Sport is a common cause of facial injuries. Depends on geographical distribution, 10% to 32% of all facial trauma cases are accounted to sporting activities according to the literature. In the following review article, sports-related facial injuries are classified based on their localization and on the principle of their treatment. Sports-specific mechanism underlying common injuries and state of the art concepts of diagnostics and surgical management, as currently practiced, are presented.

Athletic Injuries↗
PubMed2005

Attitudes of Central Collegiate Hockey Association ice hockey players toward athletic mouthguard usage.

OBJECTIVE: The purpose of this study was to examine Central Collegiate Hockey Association ice hockey players' attitudes regarding the use of athletic mouthguards and to determine the effects of mouthguard type, player position, education, and usage time with respect to attitudes. METHODS: A questionnaire measuring players' attitudes toward mouthguards was sent to certified athletic trainers (ATC) responsible for providing healthcare coverage at 10 institutions of the Central Collegiate Hockey Association (CCHA). The ATC's distributed the surveys to all the players on their respective collegiate teams. Out of a total of 265 players listed on the roosters of the CCHA, one hundred and sixty five (62%) players returned the surveys, with 158 surveys used in the analyses (60%). RESULTS: Approximately 13.3% of players (n=21) reported wearing mouthguards 50% of the time or greater during games and 3.8% (n=6) reported wearing mouthguards 50% of the time or greater during practices. Twenty-six percent (n=41) of the players never received educational information regarding using mouthguards. Thirty-nine percent (n=59) of the players reported altering mouthguards to obtain a better fit while 91% of the players were not influenced by the cost of the mouthguard. A 2 x 2 x 2 ANOVA revealed a significant interaction among player position and mouthguard type with respect to player attitudes (F(1,131) = 4.96, P < 0.05), with defensive players having more negative attitudes toward mouthguard usage compared to offensive players. CONCLUSION: No one specific factor affecting attitudes was identified, however, players reported limited educational opportunities to learn about the effectiveness of mouthguards. Therefore, coaches, dentists, and healthcare providers should engage in more preventive educational programs to increase player attitudes and compliance.

Analysis of Variance↗
PubMed2003

Management of maxillofacial injuries.

Maxillofacial injuries account for 5% of all acute attendances at accident and emergency units, and are often seen in the multiply injured patient. A systematic method of examining and investigating these patients is required for all staff involved with trauma patients and an understanding of the principles of their management will help to prioritize treatment needs.

Forecasting↗
PubMed1993

Dental visits for orofacial injury: defining the dentist's role.

There were an estimated 5.9 million episodes of care for orofacial trauma in the U.S. private practice sector in 1991. More than 4 million were seen by general dental practitioners, the rest by specialists. An in-depth understanding of the injuries and the extent and cost of the care could establish a focused injury prevention strategy.

Adolescent↗
PubMed1995

The incidence of orofacial injuries in sports: a pilot study in Illinois.

This pilot study of sports-related injuries in Illinois confirms that football players do not encounter orofacial injuries as often as other athletes. The authors attribute this to mandatory use of faceguards and mouth protectors in football and recommend that mouthguards be used by all players of contact sports.

Athletic Injuries↗
PubMed1998

Knowledge and attitudes of Arizona high-school coaches regarding oral-facial injuries and mouthguard use among athletes.

The authors assessed high-school athletic coaches' perceptions about oral-facial injuries and mouthguard use in sports that do not mandate mouthguard use. About 72 percent of the coaches said that their athletes sustained oral-facial injuries, 28 percent that some athletes used mouthguards regularly, 48 percent that athletes had sustained injuries and did not use mouthguards regularly, and 31 percent said they would not encourage mouthguard use. Advocacy for mouthguard use should focus on coaches, coaches' associations and rule-making organizations.

Adolescent↗
PubMed2000

Equine dental disease. Part 3: A long-term study of 400 cases: disorders of wear, traumatic damage and idiopathic fractures, tumours and miscellaneous disorders of the cheek teeth.

Of 400 horses referred because of dental disorders, 349 cases were diagnosed as suffering from primary disorders of their cheek teeth. Details of 104 of these cases are presented, including 44 cases with abnormalities of wear, 26 cases with traumatic damage, 24 cases with idiopathic fractures and 10 cases with miscellaneous cheek teeth disorders including oral tumours. The long-term response to treatment was excellent in most cases, even in cases with residual secondary periodontal disease.

Animals↗
PubMedDate not supplied

Dental emergencies in children seen at University College Hospital (UCH), Ibadan, Nigeria--5 year review.

A five year review of 106 children aged less than 17 years who presented at the accident and emergency unit of UCH, Ibadan for an after hour dental emergency services is presented. More than 50% of the children were males. The dominant age group was 0-4 years and the most common aetiology was road traffic accident. Jaw fractures and soft tissue lacerations were the commonest presentation and fractured limbs were the most common concomitant injuries. The need to abolish street trading among children is emphasised as this has been recognised to expose children to hazards of the road since most of the children were pedestrians.

Accidental Falls↗
PubMed1999

[Prevention of dental trauma].

Dental trauma is for people under 25 years of age a larger threat than caries and periodontal diseases. Protrusion of the upper front teeth in youth should therefore be corrected by orthodontic treatment. By doing contact-sports the use of the mouth guard is necessary. Since several different types are available, one has to make a correct choice specified by the kind of sport. The statement that it is more important to use an apparatus than just to own it sounds logically, but is often not followed in daily live.

Age Distribution↗
PubMed2004

Management of traumatic facial injuries.

Whether minor or major, traumatic injuries to the maxillofacial area have far-reaching physical and emotional effects. Because the dentition dictates facial form and function, the oral and maxillofacial surgeon, a dental specialist with a minimum of four years of hospital-based surgical training, is uniquely qualified to manage these injuries. At times, the expertise of the general dentist and other dental specialists may be needed to provide definitive care. Several cases are provided to illustrate management of facial trauma.

Accidental Falls↗
PubMed1991

Emergency treatment of athletic injuries.

Dental-related injuries continue to occur in high incidence in sporting events. Many of these injuries are preventable although the use of protective mouthguards remains sparce unless the rules of a particular sport explicitly dictate use during participation. Thus many athletes sustain dental-related injuries resulting in deformity and discomfort which may persist throughout their lives. Acute management of these injuries often determines the extent to which the dental disability is recoverable. It is essential that those health care professionals working directly with the athletes during competition reinforce the importance of protection and prevention as well as refine the skills necessary for immediate management of the injuries. Guidelines for management of dental injuries should be established by the team dental consultant and should be reviewed continually by team athletic trainers and team physicians. Often the primary care professional will determine the fate and ultimate recovery from the variety of dental injuries encountered regularly in sports.

Athletic Injuries↗