加载中

    Clinical characteristics and treatment of multiple site comminuted mandible fractures. Li Zhi,Li Zu-Bing Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery Multiple site comminuted mandibular fractures are the result a concentrated and prolonged force on a region of the mandible. The purpose of this retrospective study was to investigate the clinical characteristics of these fractures in China, as well as review our experience with these types of fractures. Twenty-one patients treated for multiple site comminuted mandibular fractures were included in the study. The case records were reviewed, with particular attention to the patient's gender, age, aetiology of injury, area and extent of comminution, concomitant injuries and treatment methods. Sixteen of the 21 patients were males. Ages ranged between 18 and 48 years, with a mean of 34.81 years. Traffic accidents were responsible for the majority (42.86%) of the fractures. Concomitant injuries were uncommon. Treatment was with open reduction with rigid internal fixation and maxillo-mandibular fixation. We recommend that fixation and reconstruction of the mandible with reconstruction plates should be the treatment of choice and MMF should be used as an adjunct. 10.1016/j.jcms.2010.04.009
    Post-traumatic bifid condyle: the pathogenesis analysis. Li Zhi,Djae Kamardine Ahmed,Li Zu-Bing Dental traumatology : official publication of International Association for Dental Traumatology This study investigated the characteristic of bifid condyle secondary to temporomandibular joint (TMJ) trauma, aiming to analyse the pathogenesis of post-traumatic bifid condyle. Four cases identified as having bifid condyle secondary to TMJ trauma were involved in this study. The relative information extracted from the case records included patients' complaint, history of injury and radiographic appearance, which were used to analyse the characteristic and pathogenesis of post-traumatic bifid condyle. The results indicated that there was a correlation between condylar trauma degree and bifid condylar head appearance after trauma. For severe condylar fracture, it might result in Y-shaped condyle associated with TMJ ankylosis; and condylar groove could be associated with the slight trauma in condyle articulating surface. In conclusion, as a specific entity, post-traumatic bifid condyle may develop in cases with insufficient remodelling capacity after condyle trauma, and it seems that the severity degree of trauma, the site of trauma and its relation to the insertion of the lateral pterygoid muscles are factors associated with the appearance and orientation of bifid condyle. 10.1111/j.1600-9657.2011.01035.x
    Why should we start from mandibular fractures in the treatment of panfacial fractures? Yang Rongtao,Zhang Chi,Liu Yong,Li Zhi,Li Zubing Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons PURPOSE:Clinically, the "bottom-up and outside-in" sequence is usually applied in the management of panfacial fractures (PFFs). However, findings to prove that a sequence initiated from the mandible is reasonable are not available. Our objective was to describe the distribution of mandibular fractures in PFFs and investigate the basis for initially addressing the mandible when treating PFFs. PATIENTS AND METHODS:The data from 107 patients with PFFs from 1998 to 2008 were analyzed retrospectively. All cases were treated with the "bottom-up and outside-in" sequence. RESULTS:The most common sites of mandibular fractures in PFFs were the symphysis and condyle. The most common type of fracture was the isolated linear fracture. No correlations between fracture type and the incidence of mandibular fractures and other fractures in PFFs were observed; however, PFFs with simple mandibular fractures had fewer complications and better treatment effects than PFFs with complex mandibular fractures. Significant differences between mandibular fractures in PFFs and general mandibular fractures were found. The type distribution in the former was simpler than that in the latter; the severity was also less serious. Most PFF patients treated with the proposed sequence presented with satisfactory effects. CONCLUSIONS:Considering the important role of the mandible in facial bones, the results have provided evidence of the feasibility of the "bottom-up and outside-in" approach in the treatment of PFFs. However, some PFFs remain difficult to treat. Thus, additional studies are necessary. 10.1016/j.joms.2011.11.006
    Maxillofacial injuries in infants and preschools: a 2.5-year study. Yang Rong-Tao,Li Zhi,Li Zu-Bing The Journal of craniofacial surgery PURPOSE:This study aims to evaluate the epidemiology of maxillofacial injuries in infants and preschools. PATIENTS AND METHODS:The data from 110 infants and preschools with maxillofacial injuries from October 2010 to March 2013 were analyzed retrospectively. RESULTS:The male-to-female ratio was 1.89:1. The peak age was 1 to 3 years (53.64%). Accident falls (76.36%) were the major cause. A total of 166 soft-tissue injuries were found in 103 patients, 102 dental traumas in 36 patients, and 53 maxillofacial fractures in 33 patients. The most common sites of soft-tissue injuries included the gingiva (17.47%), lower lip (13.86%), upper lip (13.25%), and chin (12.05%), and the majority were lacerations (77.71%). Dental traumas occurred mainly in incisors (81.37%) and the lower arch (60.78%). Of the 53 fractures, the most common sites were the condyle (45.28%), symphysis (22.64%), and mandibular body (16.98%); 28 (52.83%) were treated by operation and 25 (47.17%) by conservative treatment. CONCLUSIONS:Maxillofacial injuries in infants and preschools exhibit specific epidemiological features. These are related to anatomic, physiologic, and psychologic development in infants and preschools. 10.1097/SCS.0000000000000760
    The use of resorbable plates in association with dental arch stabilization in the treatment of mandibular fractures in children. Li Zhi,David Ongodia,Li Zu-Bing Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery PURPOSE:The purpose of this study was to investigate the effect of resorbable plate fixation in association with dental arch stabilization in the treatment of displaced mandibular fractures in children. PATIENTS AND METHODS:Thirteen children (5 girls and 8 boys, age range 2 years 5 months to 12 years 2 months) with displaced mandibular fractures were included in this case series. Open reduction by intraoral approach was performed on these patients, and the fractures were fixed using resorbable plates and monocortical screws placed at the lower border of the mandible. At the same time, an arch bar or orthodontic wire splint was anchored using stainless steel wires or resin on the teeth to stabilize the whole mandibular dental arch. Postoperatively, follow-up was undertaken to evaluate the fracture healing, mandible movement, and mandible growth. RESULTS:Postoperatively, all patients achieved uneventful healing; premorbid occlusion restoration and wound healing were achieved, along with unimpaired function and normal growth and development of the mandible. Complications such as damage to tooth buds, infection, malunion, and nonunion were not encountered in these patients. CONCLUSION:Resorbable plates use in association with dental arch stabilization can provide good stabilization for mandibular fractures and is a promising approach for the treatment of displaced mandibular fractures in children. 10.1016/j.jcms.2013.07.025
    Resorbable plates for fixation of complicated mandibular fractures in children. Ongodia David,Li Zhi,Xing Wu Zhong,Li Zu-Bing Journal of maxillofacial and oral surgery PURPOSE:The purpose of this article was to review our experience in the treatment of complicated mandibular fractures in children using resorbable plates. PATIENTS AND METHODS:Records of 14 patients who sustained and presented to our department with complicated fractures of the mandible, and were treated with resorbable plates were retrieved. Permission was sought from and granted by the institution ethical committee. Data extracted included patients' gender, age, etiology of fracture, nature of fracture and site of the fracture. RESULTS:Of the 14 patients, there were 10 males and 4 females with a male to female (M:F) ratio of 2.5:1. Their ages ranged from 6 to 15 years, with a mean of 10.14 years. The etiology of the fractures included road traffic accidents (n = 11) and falls (n = 3). Most of the fractures were sustained on the body of the mandible. Majority of the patients had displacement of the fracture segments; 2 patients had comminuted fractures. All the fractures were treated using resorbable plates and healed uneventfully. CONCLUSION:Whereas the number of patients in this case series was small, it is worth noting that children sometimes present with complicated fractures of the mandible, thereby necessitating open reduction and internal fixation. Resorbable plates when available and affordable, are an effective option for open reduction and internal fixation of such fractures. 10.1007/s12663-013-0501-z
    Resorbable plates for the fixation of isolated mandibular angle fracture. Yang Rong-tao,Lv Kun,Zhou Hai-hua,Li Zhi,Li Zu-bing The Journal of craniofacial surgery PURPOSE:This study was designed to evaluate the results in isolated mandibular angle fractures treated with resorbable plates and to summarize experiences of the application of resorbable plates. PATIENTS AND METHODS:Ten patients (6 men and 4 women) with isolated displaced mandibular angle fracture were included in this case series. Open reduction by intraoral or extraoral approach was performed, and the fractures were fixed using single or dual resorbable plates. Postoperatively, follow-up was undertaken to evaluate the fracture healing and the degradation of resorbable plates. RESULTS:All the fractures healed without complications during the follow-up period. No screw or plate fractured during the surgery, no dislocation of the fracture segment after the fixation by resorbable plates, and no foreign body reaction related with resorbable plates were observed. CONCLUSIONS:With proper indication, resorbable plates are suitable for the fixation of isolated mandibular angle fractures. Single or dual resorbable plates by intraoral or extraoral approach can be individualized on the basis of the patients' condition. 10.1097/SCS.0000000000001349
    Applications of Computer-Assisted Navigation for the Minimally Invasive Reduction of Isolated Zygomatic Arch Fractures. Li Zhi,Yang Rong-Tao,Li Zu-Bing Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons PURPOSE:Computer-assisted navigation has been widely used in oral and maxillofacial surgery. The purpose of this study was to describe the applications of computer-assisted navigation for the minimally invasive reduction of isolated zygomatic arch fractures. PATIENTS AND METHODS:All patients identified as having isolated zygomatic arch fractures presenting to the authors' department from April 2013 through November 2014 were included in this prospective study. Minimally invasive reductions of isolated zygomatic arch fractures were performed on these patients under the guidance of computer-assisted navigation. The reduction status was evaluated by postoperative computed tomography (CT) 1 week after the operation. Postoperative complications and facial contours were evaluated during follow-up. Functional recovery was evaluated by the difference between the preoperative maximum interincisal mouth opening and that at the final follow-up. RESULTS:Twenty-three patients were included in this case series. The operation proceeded well in all patients. Postoperatively, all patients displayed uneventful healing without postoperative complication. Postoperative CT showed exact reduction in all cases. Satisfactory facial contour and functional recovery were observed in all patients. The preoperative maximal mouth opening ranged from 8 to 25 mm, and the maximal mouth opening at the final follow-up ranged from 36 to 42 mm. CONCLUSIONS:Computer-assisted navigation can be used not only for guiding zygomatic arch fracture reduction, but also for assessing reduction. Computer-assisted navigation is an effective and minimally invasive technique that can be applied in the reduction of isolated zygomatic arch fractures. 10.1016/j.joms.2015.03.033
    Mechanics in the Production of Mandibular Fractures: A Clinical, Retrospective Case-Control Study. Zhou Haihua,Lv Kun,Yang Rongtao,Li Zhi,Li Zubing PloS one As the mandible is susceptible to fracture, the aim of this study was to use multivariate logistic regression analysis to identify and distinguish various internal factors that may influence the location of mandibular fractures. The study included 1131 patients with maxillofacial fractures during the period from January 2000 to December 2009 to evaluate the association of mandibular fracture location (unilateral symphysis, body, angle, condylar, or bilateral condylar fractures) with various internal factors. Among the 1131 patients, 869 had mandibular fractures. Data on age, sex, soft tissue injuries, dental trauma, and maxillofacial fracture type were collected and analyzed using multivariate logistic regression. In total, 387, 210, 139, 319, and 172 patients were diagnosed with unilateral symphysis, body, angle, unilateral, or bilateral condylar fractures, respectively. The dental trauma in patients with bilateral condylar fractures differed from that in patients with unilateral condylar fractures. Patients with mandibular fracture (unilateral symphysis, body, unilateral or bilateral condylar) possessed an approximately equal risk of soft tissue injuries in the mandible. Patients with either unilateral or bilateral condylar fractures were associated with a low risk of mandibular angle fracture (OR < 1). Similarly, patients with mandibular angle fracture were associated with a low risk of unilateral or bilateral condylar fractures (OR < 1). Moreover, patients with symphysis fracture were associated with a low risk of bilateral condylar fractures (90 of 387 [23.3%], OR 0.899). By contrast, patients with bilateral condylar fractures were associated with a high risk of symphysis fracture (90 of 172 [52.3%], OR 17.38). Patients with condylar fractures, particularly those with bilateral condylar fractures, were infrequently associated with secondary mandibular fractures. Mandibular fractures tended to have less of an association with midfacial fractures. The occurrence of mandibular fractures is strongly correlated with age, sex, soft tissue injuries, dental trauma, and the pattern and position of the maxillofacial fractures in patients. 10.1371/journal.pone.0149553
    Relationship between post-extraction pain and acute pulpitis: a randomised trial using third molars. Zhang Wei,Dai Yong-Bo,Wan Peng-Cheng,Xu Dong-Dong,Guo Yi,Li Zhi International dental journal INTRODUCTION:The aim of the present study was to examine the relationship between post-extraction pain and acute pulpitis in third molars. METHODS:This study was a randomised controlled trial. Sixty patients requiring removal of a single maxillary third molar with acute pulpitis were included and randomly divided into two groups: group A (n = 30); and group B (n = 30). In group A, third molars were directly extracted, and group B received endodontic therapy (pulp chamber opening and drainage) and underwent extraction 24 hours later, aiming to eliminate the acute inflammation. Another 30 patients requiring removal of a single maxillary third molar and with the same inclusion criteria but without caries or acute pulpitis were recruited into group C, in which the maxillary third molars were also directly extracted. The level of postoperative pain reported each day among the three groups was statistically evaluated. RESULTS:On the first, second and third days after surgery, there was a statistically significant difference between group A and group B and between group A and group C, but there was no statistically significant difference between group B and group C. CONCLUSION:The results of the present study indicate that there is more pain when third molars with acute pulpitis are directly removed compared with the pain level of the removal of third molars without acute pulpitis. 10.1111/idj.12249
    Removal of a large number of foreign bodies in the maxillofacial region with navigation system. Yang Chan-Yuan,Yang Rong-Tao,He San-Gang,Li Zhi Dental traumatology : official publication of International Association for Dental Traumatology The removal of a large number of foreign bodies in the maxillofacial region can be complicated and challenging. In this case report, a specific strategy for removal of multiple foreign bodies in the maxillofacial region is presented. A girl diagnosed with 24 foreign bodies in her left lower face and neck underwent the surgery using a computer-assisted navigation system. A specific strategy was used in this case, which included from one sub-region to the next and from the easiest to the most difficult. This strategy is recommended for the removal of a large number of foreign bodies in the maxillofacial region with a navigation system. 10.1111/edt.12313
    Predicting postoperative facial swelling following impacted mandibular third molars extraction by using artificial neural networks evaluation. Zhang Wei,Li Jun,Li Zu-Bing,Li Zhi Scientific reports Patients' postoperative facial swelling following third molars extraction may have both biological impacts and social impacts. The purpose of this study was to evaluate the accuracy of artificial neural networks in the prediction of the postoperative facial swelling following the impacted mandibular third molars extraction. The improved conjugate grads BP algorithm combining with adaptive BP algorithm and conjugate gradient BP algorithm together was used. In this neural networks model, the functional projective relationship was established among patient's personal factors, anatomy factors of third molars and factors of surgical procedure to facial swelling following impacted mandibular third molars extraction. This neural networks model was trained and tested based on the data from 400 patients, in which 300 patients were made as the training samples, and another100 patients were assigned as the test samples. The improved conjugate grads BP algorithm was able to not only avoid the problem of local minimum effectively, but also improve the networks training speed greatly. 5-fold cross-validation was used to get a better sense of the predictive accuracy of the neural network and early stopping was used to improve generalization. The accuracy of this model was 98.00% for the prediction of facial swelling following impacted mandibular third molars extraction. This artificial intelligence model is approved as an accurate method for prediction of the facial swelling following impacted mandibular third molars extraction. 10.1038/s41598-018-29934-1