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Assessment of Reduction and Stabilization Adequacy of Mandibular Angle Fractures treated by mini plates Intraorally

تقييم كفاية الرد و استقرار التثبيت لكسور زاوية الفك السفلي بالصفائح الصغيرة من داخل الفم

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 Publication date 2015
and research's language is العربية
 Created by Shamra Editor




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The purpose of this study was to evaluate the reliability of a single malleable noncommpression titanium miniplate in fixation and stability of fractures of the mandibular angle using two approaches(.transbuccal and intra-oral approach, or intra-orally alone) . The research sample included 20 patients from patients who attended AL Assad University Hospital with Unilateral or bilateralun-comminuted mandibular angle fractures in the period between September 2011 and October 2013. The research sample was divided into two groups depending on the two approaches that have been used . Adequacy of the reduction and stability of fixation were evaluated through Radiographic examinations immediately after surgery. Postoperative assessment was based on clinical examination after 1 month, 6 monthes and a year to evaluate: Occlusion, Masticatory efficiency, Maximum mouth opening range, and Other complications(infection –mini-plate exposure). The results of the present study showed that there were statistical difference between the two approaches(transbuccal and intra-oral approach, or intra-orally alone) regarding Occlusion, Masticatory efficiency and Other complications after 1 and 6 months while there was no statistical difference between the approaches after 1 year . we Concluded that using the combined transbuccal/oral approach was the best regarding(infection and mini-plate exposure) and compared with intra-oral approach .


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Research summary
تهدف الدراسة إلى تقييم كفاية الرد واستقرار التثبيت لكسور زاوية الفك السفلي باستخدام صفيحة صغيرة مفردة غير ضاغطة عبر مقاربتين جراحيتين: من داخل الفم ومن داخل الفم عبر الخد. شملت الدراسة 20 مريضاً من مشفى الأسد الجامعي، وتم تقسيمهم إلى مجموعتين. تم تقييم النتائج من خلال الصور الشعاعية والفحوصات السريرية بعد شهر، ستة أشهر، وسنة. أظهرت النتائج فروقاً ذات دلالة إحصائية لصالح المقاربة عبر الخد بعد شهر وستة أشهر، بينما لم تكن هناك فروق بعد سنة. خلصت الدراسة إلى أن المقاربة عبر الخد كانت الأفضل من حيث عدم انكشاف الصفيحة وتطور الإنتان، وكانت أكثر سهولة مقارنة بالمقاربة الفموية.
Critical review
دراسة نقدية: الدراسة قدمت معلومات قيمة حول فعالية استخدام الصفائح الصغيرة في تثبيت كسور زاوية الفك السفلي. ومع ذلك، يمكن توجيه بعض النقد البناء لتحسين البحث في المستقبل. أولاً، حجم العينة كان صغيراً نسبياً (20 مريضاً فقط)، مما قد يؤثر على تعميم النتائج. ثانياً، لم يتم توضيح تفاصيل كافية حول المعايير المستخدمة لتقييم الفعالية المضغية والإطباق، مما قد يؤثر على دقة النتائج. ثالثاً، كان من الممكن أن تكون فترة المتابعة أطول من سنة واحدة لتقييم الاستقرار الطويل الأمد للصفائح. وأخيراً، كان من المفيد تضمين مجموعة مقارنة تستخدم تقنيات تثبيت أخرى للحصول على صورة أكثر شمولية.
Questions related to the research
  1. ما هي الأهداف الرئيسية للدراسة؟

    تهدف الدراسة إلى تقييم كفاية الرد واستقرار التثبيت لكسور زاوية الفك السفلي باستخدام صفيحة صغيرة مفردة غير ضاغطة عبر مقاربتين جراحيتين: من داخل الفم ومن داخل الفم عبر الخد.

  2. ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟

    أظهرت النتائج فروقاً ذات دلالة إحصائية لصالح المقاربة عبر الخد بعد شهر وستة أشهر، بينما لم تكن هناك فروق بعد سنة. وكانت المقاربة عبر الخد الأفضل من حيث عدم انكشاف الصفيحة وتطور الإنتان، وكانت أكثر سهولة مقارنة بالمقاربة الفموية.

  3. ما هي المعايير المستخدمة لتقييم كفاية الرد واستقرار التثبيت؟

    تم تقييم كفاية الرد واستقرار التثبيت من خلال الصور الشعاعية والفحوصات السريرية التي تضمنت الإطباق، الفعالية المضغية، والمضاعفات المتطورة بعد العمل الجراحي مثل الإنتان وانكشاف الصفيحة.

  4. ما هي التوصيات التي قدمتها الدراسة؟

    أوصت الدراسة بإجراء أبحاث أشمل وبعينة مرضى أكبر وعلى فترة زمنية أطول بالمقاربتين من داخل الفم وعبر الخد، وكذلك بإجراء ندوات علمية وورشات عمل حول كيفية تطبيق الصفائح والبراغي في معالجة كسور الفك السفلي.


References used
In .Emergency airway management in the traumatized patient :MUSKAT, P.C .Fonseca R, editors: Oral and maxillofacial surgery. Saunders, 2009,34-35
American college of surgeons committee on trauma: Advanced trauma life support, 7th ed, Chicago, 2004,81-83
MANSON, P.N; HOOPES, J.E: Structural pillars of the facial skeleton: an approach to the management of Le Fort fractures, Plast Reconstr Surg, 1980,54-57
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