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Traumatic dental injuries (TDI) are a prevalent public health concern, requiring preventive measures as well as timely and appropriate interventions to prevent adverse outcomes and optimize patients' prognosis. Although dental trauma injuries require prompt clinical intervention, some challenges persist in effectively managing these injuries. In dental traumatology, the implementation of public health policies assumes critical importance, these policies play an important role in addressing preventive measures and mitigating the repercussions of TDI. This review aims to emphasize the importance of developing comprehensive public health policies in dental traumatology, recognizing the strategic importance of this approach and its benefits. By proactively addressing issues associated with dental injuries, these policies have extensive implications for individual quality of life and public health in general. Furthermore, this review will present a suggested structured framework for the development of public health policies, encompassing key domains including prevention, intervention, and education in dental traumatology. The creation and implementation of these policies will address dental trauma through prevention programs, research, and development, and will provide a significant step toward enhancing the well-being of the population and dental trauma victims' prognosis promoting a more resilient healthcare system.

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BACKGROUND/AIMS: Domestic violence (DV) encompasses a series of abusive behaviors, perpetrated in a family environment, against individuals of all ages and genders. Injuries to the head, neck, and face are frequent findings among victims of abuse, negatively impacting their quality of life. Although oral and maxillofacial injuries (OMFI) and traumatic dental injuries (TDI) are commonly diagnosed among DV victims, their prevalence is still unknown. This systematic review was aimed to assess the prevalence of OMFI and TDI among victims of DV. METHODS: The protocol of the review was registered in PROSPERO (CRD42023424235). Literature searches were performed in eight electronic databases, up to August 7th, 2023. Observational studies published in the Latin-roman alphabet and reporting the prevalence of OMFI and/or TDI were included. The Joanna Briggs Institute's critical appraisal tool, checklist for prevalence studies, was used for quality assessment. Results were presented as qualitative and quantitative syntheses. RESULTS: Seventeen studies, totaling 12,375 victims of domestic violence, were included. Meta-analyses showed an overall prevalence of 29% (95% CI: 15%-48%, I2 = 99%) and 4% (95% CI: 1%-10%, I2 = 98%) for OMFI and TDI, respectively. Higher pooled prevalence for OMFI (41%, 95% CI: 13%-46%, I2 = 99%) was demonstrated in samples with only women. OMFI was less prevalent (20%) among DV victims under 18, while TDI was lower among adults (1%). Hospital samples presented higher pooled prevalence of OMFI (32%), and forensic data from fatal victims presented higher prevalence of TDI (8%). CONCLUSION: The overall prevalence of OMFI and TDI in DV victims was 29% and 4%, respectively. Women victims of DV presented higher rates of OFMI (41%) and TDI (6%).

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BACKGROUND/AIM: Maxillofacial trauma resulting from intimate partner violence (IPV) represents an important oral health problem. In this sense, the aim of this study was to investigate the spatial-temporal distribution of maxillofacial trauma resulting from IPV against women, using a geostatistical approach. MATERIALS AND METHODS: An ecological study was carried out including the analysis of confirmed IPV cases against women treated at a Center for Forensic Medicine and Dentistry over a four-year observation period, as well as the evaluation of population data from the victims' places of residence extracted from the last demographic census of the Brazilian Institute of Geography and Statistics. Statistical analysis included: (i) finite mixture modeling to establish incidence trajectory patterns; (ii) Getis-Ord indicator (Gi*) for spatial autocorrelation; (iii) spatial regression analysis (p < .05). RESULTS: Two distinct trajectory patterns (TP1 and TP2) related to IPV incidence were identified using finite mixture modeling, suggesting spatial-temporal disparities at the regional level. In TP1, it was observed that IPV incidence was relatively low and remained stable over time, covering almost two-thirds (62.0%) of investigated spatial units. TP2 was characterized by higher IPV incidence with a tendency to increase in the last year, including more than one-third of neighborhoods (38.0%). Autocorrelation analysis showed a predominance of hot areas (hotspots) in the Eastern zone (p < .05) and in the Western zone (p < .05); and cold areas (coldspots) in the Northern zone (p < .05). In addition, statistically significant association was observed among neighborhoods with higher percentage of households with family householder without income and higher incidence of maxillofacial trauma resulting from IPV against women (ß = 5.305; SE = 1.741; p = .002). CONCLUSIONS: The findings indicate an association between higher IPV incidence against women, maxillofacial trauma, and socio-spatial vulnerability.

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To evaluate retrospectively the epidemiological characteristics of the prevalence, type and treatment modalities of the condylar mandibular fractures. Data of all patients who underwent surgical or nonsurgical management for condyle mandibular fracture were collected. The study was conducted to assess the trauma etiology, age group, gender, treatment method, anatomic distribution of injury and complications by reviewing patients' records. There were 139 patients with 171 mandibular condylar fractures. Among these patients, 85% were men, with an overall male-to-female ratio of 5.6:1. The highest occurrence of trauma was in the 21-30 years age group. The most frequently observed etiology was motorcycle traffic accidents and the subcondylar region was the most common location with 109 fractures. There was statistically significant difference between treatments (p < 0,001). In the nonsurgical treatment group, the prevalence of complications was observed compared to the surgical group (p < 0.001). The predominant complications were: mouth opening limitation, mandibular deviation, malocclusion, temporomandibular disorder, paresthesia and facial paralysis. Considering the limitations of this study, subcondylar fractures were the most frequent, especially in men aged 21-30 years, and the surgical treatment showed the fewest complications.

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Study Design: Face and content validation of a surgical simulation model. Objective: Open reduction and internal fixation in displaced subcondylar mandibular fractures is standard care. This requires an extraoral (eg: retromandibular, transparotideal) or intraoral approach. An intraoral approach requires further training since specialized instrumentation such as the 90° screwdriver system and endoscopes might be needed. Currently, no simulation models are available for training residents in intraoral reduction and fixation of subcondylar mandibular fractures. Therefore, we present a validated simulation model for intraoral treatment of subcondylar mandibular fractures. Methods: Based on a computer tomography data set, we designed and printed a 3D model of a mandible with a unilateral subcondylar fracture. To simulate intraoral work depth, it was positioned inside a dental phantom. We tested the model by a group of experts (n = 8), simulating intraoral reduction and fixation of a unilateral subcondylar fracture, using a 90° screwdriver system, a 1.0 subcondylar plate (lambda), and 5-6 mm screws.We assessed Face and Content validity by survey. Results: We provided an open-source printable fracture model. Printing costs were approximately US $10. Experts "Agreed" the model resembling the real scenario and its use for training intraoral reduction and fixation of subcondylar mandibular fractures. Conclusions: We developed a low cost, reproducible, open-source simulator for subcondylar mandibular fractures. Face and Content validity was achieved through evaluation by a group of experts.

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To establish a set of variables that define a predictive profile of events of maxillofacial trauma resulting from interpersonal violence, we analyzed sociodemographic variables and clinical characteristics of injuries recorded in three tertiary care hospital centers in Chile. To assess the relation between categories, we applied a multiple correspondence analysis. We identified 567 cases. Two dimensions explained 53.4% of the model. The first dimension was composed of variables related to the severity of the injury: medical-legal prognosis (.574), type of trauma (.511), and the destination of the patient (.332); the second dimension was composed of variables related to the typology of interpersonal violence: type of violence (.398) and sex of the patient (.370). Two profiles were recognized: women, victims of domestic violence, with lesions affecting mainly soft tissues and not requiring hospitalization and men, victims of community violence, with lesions involving fractures associated with greater severity and requiring hospitalization. There are two key dimensions in the diagnosis of maxillofacial trauma resulting from interpersonal violence: severity of the injury and typology of the interpersonal violence. Exploring these predictive profiles can be a useful complement to the current screening tools of violence in clinical practice.

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O hipoclorito de sódio (NaOCl), bastante difundido nos tratamentos endodônticos como uma solução de irrigação eficaz, pode causar complicações graves através da extrusão do mesmo nos tecidos periapicais. O objetivo desse estudo é relatar um caso clínico de extravasamento de hipoclorito durante o tratamento endodôntico, evidenciando a conduta terapêutica. Paciente do sexo feminino, 52 anos, comparece ao setor de urgências e emergência do Hospital da Restauração Governador Paulo Guerra, Recife-PE, cursando com aumento de volume em hemiface direita de aspecto eritematoso, difuso, com sintomatologia dolorosa e sensação de ardência, e necrose tecidual sugestiva de extrusão do NaOCl através dos tecidos periapicais. Foi realizada a limpeza copiosa, desbridamento, drenagem cirúrgica e antibioticoprofilaxia. Observou-se redução do edema e boa cicatrização tecidual intraoral, evidenciando-se que, embora seja rara, é essencial o manejo rápido e preciso diante dessa condição, além da terapêutica medicamentosa a fim de se prevenir infecções secundárias... (AU)

Sodium hypochlorite (NaOCl), widely used in endodontic treatments as an effective irrigation solution, may cause serious complications through extrusion into the periapical tissues. The aim of this study is to report a clinical case of hypochlorite extravasation during endodontic treatment, highlighting the therapeutic approach. A 52-year-old female patient presented at the emergency department of Hospital da Restauração Governador Paulo Guerra, Recife-PE, complaining of a diffuse, erythematous swelling of the right hemiface, with painful symptoms and burning sensation, and tissue necrosis suggestive of extrusion of NaOCl through the periapical tissues. Copious cleaning, surgical debridement and drainage, and antibiotic prophylaxis were performed. A reduction in edema and good intraoral tissue healing were observed. Although rare, rapid and precise management of this condition is essential, as well as drug therapy to prevent secondary infections... (AU)

El hipoclorito de sodio (NaOCl), muy extendido en los tratamientos endodónticos como solución de irrigación eficaz, puede causar graves complicaciones por su extrusión en los tejidos periapicales. El objetivo de este estudio es reportar un caso clínico de extravasación de hipoclorito durante el tratamiento endodóntico, destacando el enfoque terapéutico. Paciente de sexo femenino, 52 años, comparece en el servicio de urgencias y emergencias del Hospital de Restauración Gobernador Paulo Guerra, Recife-PE, cursando con aumento de volumen en hemiface direita de aspecto eritematoso, difuso, con sintomatología dolorosa y sensación de ardor, y necrose tecidual sugestiva de extrusión del NaOCl a través de los tejidos periapicales. Se realizó una abundante limpieza, desbridamiento, drenaje quirúrgico y antibioprofilaxis. Se observó una reducción del edema y una buena cicatrización de los tejidos intraorales, lo que demuestra que, aunque sea poco frecuente, es esencial un tratamiento rápido y preciso de esta afección, además de la terapia farmacológica para prevenir las infecciones secundarias... (AU)

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OBJECTIVE: This randomized clinical trial aimed to compare the efficacy of Erich arch bars (EAB) and intermaxillary fixation (IMF) screws in reducing mandibular fractures during open reduction and internal fixation (ORIF). METHODS: A total of 28 patients with mandibular fractures were randomly allocated to either the EAB group or the IMF screws group. The study evaluated various parameters including occlusal stability, complications, duration of application, oral hygiene status, quality of life, and patient characteristics. RESULTS: The study found no significant differences in occlusal stability between the EAB and IMF screw groups. However, the application and removal times were longer for EAB compared to IMF screws. The EAB group showed a higher presence of biofilm on teeth, indicating poorer oral hygiene status compared to the IMF screws group. In terms of quality of life, patients in the EAB group reported worse results in the "handicap" domain at the 15th postoperative day. No significant differences were observed in other quality-of-life parameters. Patient characteristics were well distributed between the two groups, enhancing the reliability of the results. CONCLUSION: Both EAB and IMF screws demonstrated comparable occlusal stability for minimally displaced mandibular fractures. However, IMF screws offered advantages such as shorter application and removal times, better oral hygiene maintenance, and potentially improved quality of life in the "handicap" domain. Further studies with larger sample sizes are necessary to validate these findings and explore the stability of IMF methods in cases requiring postoperative malocclusion correction or prolonged IMF.

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As lesões na face decorrentes de mordedura humana estão entre os tipos de trauma causados por violência interpessoal. Injúrias causadas nesta região podem gerar uma série de morbidades como perdas teciduais importantes, infecções, além de cicatrizes irreversíveis quando a ferida é passível de reparo, portanto, os cuidados pós-trauma devem visar à minimização de cura, além da funcionalidade, buscando o máximo de estética possível. Este trabalho tem como objetivo relatar um caso clínico de mordida humana em região de dorso nasal, com avulsão da ponta nasal, atendida no Hospital da Restauração Governador Paulo Guerra, Recife-PE, pelo serviço de Cirurgia Buco-Maxilo-Facial. Procedeu-se com reparo primário e antibioticoterapia profilática, no qual o resultado do tratamento foi considerado satisfatório, boa cicatrização tecidual e sem queixas funcionais e estéticas... (AU)

Injuries to the face resulting from human bite are among the types of trauma caused by interpersonal violence. The injuries caused in this region, can generate a series of morbidities such as major tissue loss, infection, and irreversible scarring when the wound is repairable, therefore, posttrauma care should aim to minimize healing, in addition to functionality, seeking maximum aesthetics as possible. This paper aims to report a clinical case of human bite in the nasal dorsum region, with avulsion of the nasal tip, attended at the Hospital da Restauração Governador Paulo Guerra, Recife-PE, by the service of Oral and Maxillofacial Surgery. It was proceeded with primary repair and prophylactic antibiotic therapy, in which the result of the treatment was considered satisfactory, good tissue healing and without functional and aesthetic complaints... (AU)

Las lesiones faciales producidas por mordeduras humanas se encuentran entre los tipos de traumatismos causados por la violencia interpersonal. Las lesiones causadas en esta región pueden generar una serie de morbilidades como la pérdida de tejidos importantes, la infección y la cicatrización irreversible cuando la herida es reparable, por lo tanto, los cuidados posttrauma deben tener como objetivo minimizar la cicatrización, además de la funcionalidad, buscando la máxima estética posible. Este trabajo tiene como objetivo reportar un caso clínico de mordedura humana en la región del dorso nasal, con avulsión de la punta nasal, atendido en el Hospital da Restauração Governador Paulo Guerra, Recife-PE, por el servicio de Cirugía Oral y Maxilofacial. Se procedió a la reparación primaria y a la terapia antibiótica profiláctica, en la que el resultado del tratamiento se consideró satisfactorio, con buena cicatrización de los tejidos y sin quejas funcionales y estéticas... (AU)

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BACKGROUND: Penetrating arrow injuries of the head and neck are exceedingly rare in pediatric patients. This pathology has high morbidity and mortality because of the presence of vital organs, the airway, and large vessels. Therefore, the treatment and removal of an arrow is a challenge that requires multidisciplinary management. CASE SUMMARY: A 13-year-old boy was brought to the emergency room after an arrow injury to the frontal region. The arrowhead was lodged in the oropharynx. Imaging studies showed a lesion of the paranasal sinuses without compromising vital structures. The arrow was successfully removed by retrograde nasoendoscopy without complications, and the patient was discharged. CONCLUSION: Although rare, maxillofacial arrow injuries have high morbidity and mortality and require multidisciplinary management to preserve function and aesthetics.

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Abstract Introduction Motorcycles are used as a common means of transportation, and motorcycle accidents are responsible for a major portion of trauma injuries. Objectives The purpose of this study was to analyze the patterns of facial injuries in motorcyclists, to evaluate the types of injuries, and to investigate if the accidentrelated factors had any impact on the characteristics of the injuries. Methods This retrospective observational study included 74 patients with maxillofacial injuries following motorcycle-related accidents. Investigated data were divided into four main categories: sociodemographic, accident-related, injury-related, and treatment-related. Results All the patients were males with a mean age (±SD) of 25.03 (±9.986) years. Most accidents (n = 44, 59.4%) occurred in the evening. Most of the patients (n = 40, 54%) were traveling on motorcycle models that had maximum speed of over 120 km/h. Furthermore, 15 patients (18.9%) were under the influence of alcohol during the crashes and only one patient was wearing a helmet. Fractures of the maxillofacial bones were observed in 50 (67.5%) crash victims; 24 of them (48%) had middle third fractures, 11 (22%) had mandibular fractures, and 15 patients (30%) presented with a combination of lower, middle, and upper third fractures. Conclusion Almost all patients were not wearing helmets at the moment of the crash. The most common fractured site was the maxilla. The majority of the patients received surgical treatment. Increased enforcement of safety measures for riders and raising awareness about the dangers of motorcycle crashes are required measures to improve traffic safety and, ultimately, population health.

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Introduction Motorcycles are used as a common means of transportation, and motorcycle accidents are responsible for a major portion of trauma injuries. Objectives The purpose of this study was to analyze the patterns of facial injuries in motorcyclists, to evaluate the types of injuries, and to investigate if the accident-related factors had any impact on the characteristics of the injuries. Methods This retrospective observational study included 74 patients with maxillofacial injuries following motorcycle-related accidents. Investigated data were divided into four main categories: sociodemographic, accident-related, injury-related, and treatment-related. Results All the patients were males with a mean age (±SD) of 25.03 (±9.986) years. Most accidents ( n = 44, 59.4%) occurred in the evening. Most of the patients ( n = 40, 54%) were traveling on motorcycle models that had maximum speed of over 120 km/h. Furthermore, 15 patients (18.9%) were under the influence of alcohol during the crashes and only one patient was wearing a helmet. Fractures of the maxillofacial bones were observed in 50 (67.5%) crash victims; 24 of them (48%) had middle third fractures, 11 (22%) had mandibular fractures, and 15 patients (30%) presented with a combination of lower, middle, and upper third fractures. Conclusion Almost all patients were not wearing helmets at the moment of the crash. The most common fractured site was the maxilla. The majority of the patients received surgical treatment. Increased enforcement of safety measures for riders and raising awareness about the dangers of motorcycle crashes are required measures to improve traffic safety and, ultimately, population health.

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Introducción: : el trauma maxilofacial se considera una urgencia quirúrgica cuando está asociado con el trauma craneoencefálico (TCE). Se describirán los hallazgos demográficos más importantes en un grupo de pacientes seleccionados para el presente estudio.Describir las características sociodemográficas y clínicas de los pacientes diagnosticados con trauma maxilofacial, así como determinar las principales pautas de tratamiento y estabilización desarrolladas en un centro de tercer nivel de complejidad del municipio de Chía en Colombia. Materiales y métodos: estudio de carácter observacional y descriptivo, desarrollado para caracterizar a la población demográfica con trauma maxilofacial en la Clínica de la Universidad de La Sabana. Resultados: se analizaron 37 pacientes en el presente estudio, con una edad promedio de 35 años, y se encontró una mayor incidencia de presentación en el sexo masculino. Dentro de las causas más frecuentes se registran los eventos de tránsito en calidad de conductor de motocicleta en el 56 % de los casos; dentro de la clasificación de las fracturas, las panfaciales se encontraron en un 24,4 % de los casos, y son las más prevalentes; en el ámbito hospitalario, el 43 % de los pacientes presentaron un TCE grave. El tiempo de espera para realizar una intervención quirúrgica fue aproximadamente de 3,8 días. Finalmente, se definieron los requerimientos de manejo en la unidad de cuidados intensivos (UCI) a través de cinco variables como: uso de vasopresores, sedación, analgésicos, gastrostomía o traqueostomía y manejo adicional en la UCI. Conclusión: las instituciones deben estandarizar un protocolo de diagnóstico y manejo específico para lesiones traumáticas de acuerdo a su nivel de complejidad, ubicación geográfica y volumen de paciente con trauma maxilofaciales y trauma craneoencefálico debido a su alta prevalencia e implicaciones tanto en morbilidad como mortalidad.

Introduction: Maxillofacial trauma is considered a surgical emergency when associated with cranioencephalic trauma (CET). The most important demographic findings will be described in a group of patients selected for the present study. To describe the sociodemographic and clinical characteristics of patients diagnosed with maxillofacial trauma, as well as to determine the main treatment and stabilization guidelines developed in a third level complexity center in the township of Chía in Colombia. Materials and methods: This is a observational and descriptive study, developed by the Department of Clinical Pharmacology and Maxillofacial Surgery to characterize the demographic population with maxillofacial trauma at the Clínica de la Universidad de La Sabana. Results: We analyzed 37 patients in the present study, with an average age of 35 years, finding a higher incidence of presentation in the male gender. Among the most frequent causes; in 56% of cases, traffic events are recorded as a motorcycle driver. Within the classification of fractures, panfacial's fractures were found in 24.4% of the cases, being the most prevalent. In the hospital setting, 43% of patients had severe CET. The waiting time to perform a surgical intervention was approximately 3.8 days. Finally, management requirements were defined in the Intensive Care Unit (ICU) through 5 variables such as: use of vasopressors, sedation, analgesics, gastrostomy or tracheostomy and additional management in ICU. Conclusion: institutions must standardize a specific diagnosis and management protocol for traumatic injuries according to their level of complexity, geographic location, and volume of patients with maxillofacial trauma and cranioencephalic trauma due to its high prevalence and implications for both morbidity and mortality.

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PURPOSE: The present study aimed to assess whether there was an increase in physical aggression in women treated in Belo Horizonte, Minas Gerais, through the mandatory quarantine. METHODS: Data from a cross-sectional study were collected and analyzed, from March 1 to December 31, 2020. Additionally, data from the same period the previous year were collected for comparison. RESULTS: Of the etiologies reviewed for 2020, physical aggression had the highest percentage increase (+ 4.9%) and was the only etiology that showed a significant difference (p = 0.045). The mean age of the included patients was 34.05 years in 2019 and 33.97 in 2020, and most of the women had facial fractures, with nasal fractures being the most frequent, followed by jaw fractures. There was a significant increase (p = 0.34) in the conservative treatment of fractures from 2019 (48.6%) to 2020 (71.7%) and a minor (p = 0.088) increase in aggression toward intimate partners (2019, 40.9%; 2020, 63.9%). CONCLUSION: Physical aggression against women increased during the period of mandatory social isolation that resulted from the COVID-19 pandemic. Health professionals, including emergency services professionals, must be trained to identify victims and refer them to specialized care.

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RESUMEN Fundamento Para el manejo quirúrgico del paciente con deformidad facial resulta vital el uso del examen clínico y radiográfico de cada caso, pues en dependencia de los hallazgos se decide entre las diversas alternativas terapéuticas disponibles en este campo. Objetivo describir el comportamiento imagenológico de las deformidades faciales en pacientes adultos. Métodos se realizó un estudio descriptivo de corte transversal, en 46 pacientes mayores de 18 años, con diagnóstico de deformidad facial, los cuales acudieron al Servicio de Cirugía Maxilofacial, del Hospital Calixto García, en el período comprendido desde noviembre de 2017 a noviembre de 2019. Se analizaron las variables: tipo de tejido, magnitud, y plano en el que se evidenciaron las alteraciones. Se utilizó la prueba exacta de Fisher, con un nivel de confianza al 95 %, para determinar las relaciones analíticas entre las variables; así como los índices tau b de Kendall y el Rho de Spearman. Resultados el 45,7 % de las deformidades se presentó en ambos planos; el 50 % de ellas con magnitudes entre 11-30 mm; y en el 41,3 % de los pacientes afectaron al tejido blando. Las correlaciones entre la distribución de pacientes y los conjuntos de variables plano/tipo de tejido y plano/magnitud resultaron negativas débiles; mientras que tipo de tejido/magnitud presentó una correlación positiva moderada muy significativa, con valores de significación entre 0,001 a 0,003. Conclusión predominaron las deformidades de tejido blando, en ambos planos y con magnitudes entre 11-30 mm. Las variables imagenológicas estudiadas mostraron un comportamiento interdependiente.

ABSTRACT Background For the surgical management of the patient with facial deformity, the use of the clinical and radiographic examination of each case is vital, since depending on the findings, a decision is made between the various therapeutic alternatives available in this field. Objective to describe the imaging behavior of facial deformities in adult patients. Methods a descriptive cross-sectional study was carried out in 46 patients older than 18 years old, with a diagnosis of facial deformity, who attended the Maxillofacial Surgery Service, Calixto García Hospital, from November 2017 to November 2019. The analyzed variables were: type of tissue, magnitude, and plane in which the alterations were evidenced. Fisher's exact test was used, with a confidence level of 95 %, to determine the analytical relationships between the variables; as well as Kendall's tau b and Spearman's Rho rates. Results The 45.7 % of the deformities presented in both planes; 50 % of them with magnitudes between 11-30 mm; and in 41.3 % of the patients they affected the soft tissue. The correlations between the distribution of patients and the sets of variables plane/tissue type and plane/magnitude were weakly negative; while tissue type/magnitude presented a very significant moderate positive correlation, with significance values between 0.001 and 0.003. Conclusion soft tissue deformities predominated, in both planes and with magnitudes between 11-30 mm. The imaging variables studied showed an interdependent behavior.

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BACKGROUND/AIMS: Oral and maxillofacial trauma (OMFT) is a public health problem due to its high occurrence and demand for resources for its management and the financial and social impact of OMFT victims on the health system. The aim of this study was to conduct an 8-year prospective analysis of OMFT cases from an emergency service. MATERIALS AND METHODS: A hospital-based 8-year prospective study on OMFT and associated factors was performed on data from December 2011 to December 2019. Data regarding sociodemographic (gender, age, and skin color) and socio-economic profiles (educational level, family income, and occupation), OMFT profile (etiology, OMFT type, and treatment), associated factors [alcohol consumption and personal protective equipment (PPE) use], OMFT occurrence (injury day and hour), length of hospital stay, and cost were collected. Descriptive and inferential analyses of data were performed. RESULTS: Most OMFT cases involved men with low schooling and family income, resulting from traffic accidents. OMFT severity was associated with longer hospital stay, higher hospital costs and nonuse of PPE, midface fractures (mainly orbital-zygomatic fractures), closed reduction, and open reduction/internal fixation. Traffic accidents were the main cause of longer hospital stays for victims aged 41-60 years with better socio-economic status compared with cases that had higher hospital costs. In general, higher hospital costs were associated with victims of violence under 40 years of age, with low schooling and farmers. Alcohol consumption and non-use of PPE also contributed to increasing the length of hospital stay. CONCLUSION: Oral and maxillofacial trauma severity was associated with longer hospital stay and higher hospital costs. Associated factors such as alcohol consumption and non-use of PPE contributed to increase the length of hospital stay and OMFT severity.

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RESUMEN Fundamento Las fracturas del complejo maxilofacial constituyen cerca de la mitad de todas las fracturas, y en un gran número de pacientes se asocian a otras fracturas y lesiones. La etiología es variada, y exigen diagnóstico y tratamiento rápidos, precisos y oportunos. Resulta relevante el estudio de esta entidad, para conocer sus características como parte de la atención de urgencias; así como sus implicaciones clínica y social. Objetivo describir el comportamiento de las fracturas maxilofaciales en pacientes atendidos en el servicio de Cirugía Maxilofacial del Princess Marina Hospital, de Gaborone, Botswana. Métodos se realizó un estudio descriptivo y retrospectivo, en el servicio de Cirugía Maxilofacial del Princess Marina Hospital, en Gaborone, Botswana, durante el período de junio de 2018 a junio de 2020. Fueron incluidos todos los pacientes (N=423) con diagnóstico de trauma maxilofacial, y por consiguiente, de algún tipo de fractura de esta parte del cuerpo. Para la presentación de la información se utilizaron tablas de frecuencias absolutas y relativas. Resultados se atendieron 423 pacientes con fracturas maxilofaciales, entre los cuales predominó el sexo masculino. El grupo de edades más afectado fue el de 26-35 años; la violencia interpersonal, la causa más frecuente; y las heridas y fracturas de cráneo, las lesiones asociadas más comunes. Conclusión Se observó similitud de los resultados respecto a otros estudios publicados. La violencia interpersonal superó a los accidentes del tránsito como la causa más frecuente de fracturas maxilofaciales.

ABSTRACT Background Fractures of the maxillofacial complex constitute about half of all fractures, and in a large number of patients they are associated with other fractures and injuries. The etiology is varied, and requires fast, accurate, and timely diagnosis and treatment. The study of this entity is relevant to know its characteristics as part of emergency care; as well as its clinical and social implications. Objective to describe the behavior of maxillofacial fractures in patients treated at the Maxillofacial Surgery service of Princess Marina Hospital, Gaborone, Botswana. Methods a descriptive and retrospective study was carried out in the Maxillofacial Surgery service of the Princess Marina Hospital, in Gaborone, Botswana, from June 2018 to June 2020. All patients (N = 423) with diagnosis were included of maxillofacial trauma, and consequently, of some type of fracture of this part of the body. Absolute and relative frequency tables were used to show the information. Results 423 patients with maxillofacial fractures were attended, among which the male sex predominated. The age group most affected was 26-35 years old; interpersonal violence, the most frequent cause; and skull injuries and fractures, the most common associated injuries. Conclusion Results were similar to other published studies. Interpersonal violence exceeded traffic accidents as the most common cause of maxillofacial fractures.

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Mandible fractures compromise stomatognathic functions, requiring rehabilitation. Evaluate the effectiveness of photobiomodulation (PBM) associated with oral exercises for rehabilitation of patients with mandible fractures. In this randomized clinical trial, we compared PBM with PBM sham in 14 adults with mandibular fractures who underwent surgical intervention. The sessions were performed 24 h and 48 h after surgical procedure, and weekly for 4 weeks after hospital discharge. Both groups performed oral exercises after each PBM session. Restriction of food consistencies, mandibular mobility, pain, and facial sensitivity measured before and after the surgical procedure were the outcomes evaluated, one and 3 months after surgery. Maximum interincisal distances (MID), exercise pain, and restriction of food consistencies were also evaluated during each week of intervention. Both groups showed normal MID (> 35 mm) and food consistencies consumed 1 month after the surgical procedure, with no significant differences between them. Individuals in the PBM group had less pain response to exercise during all the weeks of intervention than the sham group (p < 0.05). The patients presented a reduction in the painful response in MID and mandibular laterality movements 1 month after surgery compared to the preoperative period. In contrast, there was an improvement in laterality in the sham group only 3 months postoperatively and persistent pain in MID. There was no significant difference in facial sensitivity within and between groups during follow-up. The performance of oral exercises associated with PBM effectively facilitated the early rehabilitation of oral functions, with significant gains in pain management.

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ABSTRACT Injuries caused by firearm projectiles in the head and neck region generally imply severe morbidity and mortality, representing an important public health problem. These injuries can be classified as: penetrating, perforating and avulsive, and the latter is the most worrisome, because they are caused by high-velocity projectiles. Low-velocity projectiles commonly cause penetrating injuries, sometimes remaining lodged in tissues, and their removal may or may not be indicated, depending on factors such as location and severity of the lesion. This paper presents the report of three clinical cases that address injuries caused by low-velocity firearm projectiles, in which they had the indication of this artifact removal, addressing the pre, trans and post-surgery procedures. And we point out that full tactical, technical and theoretical domains are required from the Oral-Maxillofacial Surgeons for being successful in the planning and success in the treatment of these lesions.

RESUMO As lesões provocadas por projetil de arma de fogo em região de cabeça e pescoço implicam, geralmente, em morbidade e mortalidades severas representando um importante problema de saúde pública. Esses ferimentos podem ser classificados como: penetrantes, perfurantes e avulsivos, sendo este último o mais preocupante, por serem ocasionados por projéteis de alta velocidade. Os projéteis de baixa velocidade causam comumente ferimentos penetrantes, permanecendo por vezes alojados nos tecidos, podendo ou não, ser indicada a sua remoção, a depender de fatores como localização e gravidade da lesão. O presente artigo traz o relato de três casos clínicos que abordam lesões por projeteis de arma de fogo de baixa velocidade, nas quais tiveram a indicação de remoção do referido artefato, abordando-se as condutas pré, trans e pós-operatórias. Observando-se que é requerido dos Cirurgiões Buco-Maxilo-Faciais, plenos domínios tático, técnico e teórico, para se obter êxito no planejamento e sucesso no tratamento dessas lesões.

RESUMO

RESUMEN: La atención de urgencia dental se desenvuelve en un contexto de estrés que afecta el comportamiento cardiovascular de los pacientes, expresado como cambios en Frecuencia Cardiaca y Presión Arterial. Se espera que posterior a la atención, estos parámetros varíen conforme se controla el cuadro clínico o se presenten complicaciones. Un estudio observacional retrospectivo recopiló los registros de Frecuencia Cardiaca y Presión Arterial de pacientes atendidos en la urgencia dental del Complejo Asistencial Barros Luco en dos ocasiones, estando la segunda consulta vinculada al primer ingreso, tanto como control post tratamiento o complicaciones derivadas. Datos fueron registrados en Microsoft Excel™ y analizados en SciStat™. 466 pacientes consultaron en dos ocasiones, concentrados entre tercera y quinta década. Los mayores registros de Presión Arterial fueron reportados en controles post atención de Pericoronaritis, infecciones de espacios anatómicos faciales y en complicaciones post tratamiento por Pulpitis, TDA e Infección de espacios anatómicos faciales. En segundas consultas por control de Pulpitis, Alveolitis, TDA, Fracturas faciales y Hemorragias post exodoncia hubo disminución. Frecuencia Cardiaca fue el parámetro con mayor variación existiendo disminución en controles y complicaciones entre consultas. El papel exacto del dolor en la respuesta cardiovascular no está bien delimitado, la interpretación de las investigaciones destinadas a estudiar esto resulta difícil, pues estímulos nociceptivos son sólo uno de los activadores de la respuesta sistémica al estrés. En el postoperatorio el dolor juega un papel importante estudiado a 48 horas, más no, en mediano y largo plazo. Existen variaciones estadísticamente significativas en algunos parámetros estudiados, los cuales pueden presentar significancia clínica a considerar en pacientes hipertensos o cardiópatas. Son necesarios estudios sobre la incidencia particular que tienen los procedimientos odontológicos en la expresión de otros marcadores del estado sistémico.

ABSTRACT: Emergency dental care develops in a context of stress that affects the cardiovascular behavior of patients, expressed as changes in heart rate and blood pressure. After care, these parameters are expected to vary as the clinical picture is controlled or complications occur. A retrospective observational study compiled the heart rate and blood pressure records of patients seen in the dental emergency of the Barros Luco Care Complex on two occasions, the second consultation being linked to the first admission, as well as post-treatment control or derived complications. Data was recorded in Microsoft Excel ™ and analyzed in SciStat ™. 466 patients consulted on two occasions, concentrated between the third and fifth decade. Higher Blood Pressure records were reported in post-care controls for Pericoronitis, infections of facial anatomical spaces and in post-treatment complications due to Pulpitis, ADD and Infection of facial anatomical spaces. In second consultations for control of Pulpitis, Alveolitis, ADT, facial fractures and post- extraction hemorrhages there was a decrease. Heart rate was the parameter with the greatest variation, with a decrease in controls and complications between consultations. The exact role of pain in the cardiovascular response is not well defined, the interpretation of the research aimed at studying this is difficult, since nociceptive stimuli are only one of the activators of the systemic response to stress. In the postoperative period, pain plays an important role, studied at 48 hours, but not in the medium and long term. There are statistically significant variations in some parameters studied which may present clinical significance to be considered in hypertensive or heart disease patients. Studies are needed on the particular incidence that dental procedures have on the expression of other markers of the systemic state.