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The aim of this study was to assess the characteristics of patients with coronoid fractures treated in two European centres over 10 years and to briefly review the literature. This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures and surgically treated in two European centres between 2001 and 2010. During the 10 years, 1818 patients and 523 patients with maxillofacial fractures were admitted to the two centres respectively: 21 patients (16 males, 5 females) were admitted with 21 coronoid fractures and 28 associated maxillofacial fractures. A mean age of 42.1 years was observed. The fractures were mainly the result of motor vehicle accidents, followed by assaults and falls. The most frequently observed associated maxillofacial fracture was a zygomatic fracture (13 fractures). In both centres, mandibular coronoid fractures are treated unless a severe dislocation of the fractured coronoid is observed or a functional mandibular impairment is encountered. Conservative treatment can be used, together with the open reduction and internal fixation of associated fractures. The crucial point is to prevent ankylosis, which may be prevented by correct and early postoperative physiotherapy and mandibular function. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The three-dimensional (3D) asymmetric structure of the mandible makes it necessary to analyze both its size and angle. Currently the developing 3D analysis techniques are not able to perform the simultaneous linear and angular measurements. Our aim was to evaluate mandibular asymmetry using a vector-based system by constructing 3D vectors for the mandibular functional units. Material and methods: We analyzed the 3D computed tomography images of normal control (N = 27) and asymmetric mandibles (N = 40). We created 3D vectors for the condylar, coronoid, body, gonial, and symphyseal functional units and compared the corresponding pairs of 3D vectors by calculating vector operations. Results: The vector difference and other vector components represented the individual 3D architectural pattern and severity of the asymmetric mandible. The body unit contributed most to mandibular asymmetry followed by the condylar unit. Conclusions: The results indicate that 3D vector analysis can improve our understanding of the 3D architecture of asymmetric mandibles. This type of 3D vector analysis can be a useful tool for the comprehensive evaluation of its asymmetric mandibular structure. [Copyright &y& Elsevier]

Abstract: Purpose: The aims of this study were to compare the consolidation periods in alveolar distraction osteogenesis and evaluate the effects of this condition on bone formation, bone relapse and implant success in reconstruction of resorbed edentulous mandibles. Patients and methods: Eighteen patients were underwent vertical alveolar distraction osteogenesis under the same distraction protocol, except for variations in consolidation time. After a consolidation period of 5 weeks for Group 1 and 14 weeks for Group 2, 36 implants were placed to support their dentures. Bone height and relapse were evaluated using digital orthopantomographic radiographs. Results: The radiological findings showed that the mean distraction was 6.968 mm in Group 1 and 7.031 mm in Group 2. At the end of the consolidation period, the mean bone relapse was 0.832 ± 0.135 mm in Group 1 and 0.738 ± 0.135 mm in Group 2. At the end of 6 months, the mean bone relapse was 1.380 ± 0.144 mm in Group 1 and 1.112 ± 0.144 mm in Group 2. No significant difference existed between the two groups at any time. Conclusion: Consolidation periods may be reduced in alveolar distraction osteogenesis to enable more patient comfort by providing dentures early. [Copyright &y& Elsevier]

Abstract: Background: Coronoid hyperplasia (CH) is an abnormal bony elongation of a histologically normal coronoid process. Its definitive cause remains unknown. Objectives: To analyze the possible implication of congenital hypotonia in the pathogenesis of early coronoid overgrowth. Patients and methods: Two infants with congenital hypotonia were evaluated for limited mouth aperture. Bilateral CH was diagnosed. Transoral coronoidectomy was followed by an early dynamic physiotherapy program. Results: Significant improvement of maximum interincisal opening was achieved. The review of the scientific literature proved the diagnosis of CH in the infant age group is extremely unusual and the etiology of the condition is still uncertain. Conclusions: Besides mouth opening restriction, clinical features of coronoid hyperplasia in infants can include suction or deglutition anomalies, failure to thrive and recurrent episodes of choking or aspiration pneumonia. The authors hypothesize reduced fetal mandibular movements and deglutition as a result of congenital hypotonia may lead to relative hyperactivity of the temporalis muscle that is not counterbalanced by the infra and suprahyoid muscles, thereby facilitating coronoid overgrowth. [Copyright &y& Elsevier]