99 results on '"Fabio Roccia"'
Search Results
2. Surgical Management of the Peripheral Osteoma of the Zygomatic Arch: A Case Report and Literature Review
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Umberto Autorino, Claudia Borbon, Maria Chiara Malandrino, Giovanni Gerbino, and Fabio Roccia
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Surgery ,RD1-811 - Abstract
An osteoma is a benign, slow-growing, osteogenic neoplasm with a low recurrence rate that is typically characterized by the proliferation of a compact or cancellous bone. It can be peripheral, central, or extraskeletal. Usually asymptomatic, peripheral osteomas in the maxillofacial region commonly arise in the paranasal sinuses and mandible and rarely occur in the zygomatic arch, with only six previously documented cases in the literature. Here, we present the management of a solitary peripheral osteoma of the right zygomatic arch in a 72-year-old woman and a review of the literature.
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- 2019
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3. Surgical Management of Unusual Biangular Mandibular Fractures
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Stefan Cocis, Umberto Autorino, Fabio Roccia, and Chiara Corio
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Surgery ,RD1-811 - Abstract
Bilateral mandibular angle fractures, while representing a rarity among mandibular fractures, are a huge challenge of complex management for the maxillofacial surgeon. There are still many open questions regarding the ideal management of such fractures, including the following: the removal of the third molar in the fracture line, the best surgical approach, and the fixation methods. In this report the authors present the case of 40-year-old man presenting with a bilateral mandibular angle fracture referred to the Maxillofacial Surgery Department of Turin. Open reduction and internal fixation has been made for both sides. The left side third molar was removed and the internal fixation was achieved through internal fixation with one miniplate according to Champy’s technique and transbuccal access for a 4-hole miniplate at the inferior border of the mandible. Right side third molar was not removed and fixation was achieved through intraoral access and positioning of a 4-hole miniplate along the external ridge according to Champy. An optimal reduction was achieved and a correct occlusion has been restored.
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- 2017
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4. Maxillofacial Fractures due to Falls: does Fall Modality Determine the Pattern of Injury?
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Fabio Roccia, Paolo Boffano, Francesca A. Bianchi, and Emanuele Zavattero
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etiology ,facial injuries ,accidental falls ,maxillofacial injuries ,Dentistry ,RK1-715 - Abstract
Objectives: In several epidemiological studies of maxillofacial trauma, falls were one of the most frequent causes of facial injury. The aim of this study is to analyse the patterns of fall-related maxillofacial injuries based on the height of the fall. Material and Methods: Using a systematic computer-assisted database of patients hospitalised with maxillofacial fractures, only those with fall-related injuries were considered. The falls were divided into four groups: falls from slipping, tripping or stumbling (STSF), loss of consciousness (LOCF), stairs (SAF), and height (HF). Data on the age, gender, fracture site, Facial Injury Severity Scale (FISS), facial lacerations, associated lesions, type of treatment, and length of hospital stay were also analysed. Results: This study included 557 patients (338 males, 219 females; average age 51.5 years [range 4 - 99 years]). In the over 60 age group, females were more prevalent in STSF than males. According to aetiology, STSF was the most frequent cause of maxillofacial fractures (315 patients; 56.5%) followed by LOCF (157; 28.2%), HF (55; 9.9%), and SAF (30; 5.4%). The middle third of the face was affected most frequently. After LOCF, however, the inferior third was prevalently involved. The majority of associated fractures, as well as the most severe injuries and greatest rate of facial lacerations, occurred secondary to HF. Conclusions: This study showed that fracture severity and site are influenced not only by patient age, but also by the nature of the fall.
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- 2014
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5. Pediatric mandibular fractures: Surgical management and outcomes in the deciduous, mixed and permanent dentitions
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Federica Sobrero, Fabio Roccia, Giovanni Galetta, Carlo Strada, and Giovanni Gerbino
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child ,adolescent ,fracture fixation ,mandibular fractures ,treatment outcome ,Oral Surgery - Abstract
Mandibular fractures are the most frequent type of pediatric facial traumatic injury, but their treatment remains controversial. The aim of this retrospective study was to analyze the surgical treatment and long-term outcomes of dentate mandibular fractures in children and adolescents.Patients with mandibular fractures in the dentate area who were surgically treated in the period from January 1, 2001, to December 31, 2020, were included. The following data were collected: age, gender, cause and mechanism of injury, fracture site and type, associated maxillofacial fractures, the timing of surgical treatment, Facial Injury Severity Scale (FISS) score, surgical approach, number and thickness of plates, hospitalization stay and outcome. Patients were divided into three groups: deciduous (≤6 years, group A), mixed (7-12 years, group B), and permanent (13-18 years, group C) dentitions. Statistical analyses were performed using SPSS software.During the study 91 patients (male: female ratio, 3.8:1), 4 in group A, 12 in group B, and 75 in group C, with 65 single and 52 double fractures were included. An intraoral approach was used in 87% of patients. In group C, 90% of patients were treated with fixation schemes consistent with those suggested in the literature for adults, versus 75% in groups A and B. Median follow-up time was 20 months. No tooth germ injury or facial asymmetry was observed and only six group C patients had post-operative malocclusions. Hardware removal occurred in 22% of the patients.This 20-year retrospective study shows that open reduction and internal fixation of pediatric dentate mandibular fractures caused no tooth germ damage or disturbances of mandibular growth in any dentition stage. Internal fixation schemes were similar to those used for adults, although it was necessary to adapt hardware size and position according to tooth and patient age.
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- 2023
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6. World Oral and Maxillofacial Trauma (WORMAT) project: A multicenter prospective analysis of epidemiology and patterns of maxillofacial trauma around the world
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Fabio Roccia, Oreste Iocca, Federica Sobrero, Euan Rae, Sean Laverick, Kirsten Carlaw, Peter Aquilina, Alessandro Bojino, Irene Romeo, Francesc Duran-Valles, Coro Bescos, Ignasi Segura-Palleres, Guglielmo Ramieri, Dimitra Ganasouli, Stelios N. Zanakis, Luis Fernando de Oliveira Gorla, Valfrido Antonio Pereira-Filho, Maximilian Goetzinger, Gian Battista Bottini, Daniel Gallafassi, Leonardo Perez Faverani, Haider Alalawy, Mohammed Kamel, Sahand Samieirad, Mehul Raiesh Jaisani, Sajjad Abdur Rahman, Tabishur Rahman, Timothy Aladelusi, and Ahmed Gaber Hassanein
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Male ,Adult ,Young Adult ,Skull Fractures ,Otorhinolaryngology ,Accidents, Traffic ,Humans ,Female ,Maxillofacial Injuries ,Accidental Falls ,Surgery ,Oral Surgery - Abstract
The World Oral Maxillofacial Trauma (WORMAT) project was performed to analyze the causes and characteristics of maxillofacial fractures managed in 14 maxillofacial surgery divisions over a 1-year period.The following data were collected: age, sex, cause and mechanism of maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score (FISS), associated injury, day of trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software.Between 30 September 2019 and 4 October 2020, 2,387 patients (1,825 males and 562 females [ratio 3.2:1], 47.6% aged 20-39 years [mean age 37.2 years, median 33.0 years]) were hospitalised. The main cause of maxillofacial fracture was road traffic accidents (RTA), which were statistically associated with male adults as like as assault, sport, and work (p0,05). Half of the fractures involved the middle third of the face, statistically associated with fall and assault (p0.05). Trauma in multiple locations was significantly associated with longer hospital stay (p0.05). The mean length of hospitalization was 3.9 days (95% Confidence Interval 3.7-4.2).This prospective, multicenter epidemiological study confirmed that young adult males were the ones most commonly affected by maxillofacial fracture. RTAs and assaults are statistically associated with the adult population, while falls are associated with females and older population.
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- 2022
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7. Manual versus rigid intraoperative maxillo‐mandibular fixation in the surgical management of mandibular fractures: A European prospective analysis
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Federica Sobrero, Fabio Roccia, Valentines Vilaplana, Antonio Mari Roig, Elisa Raveggi, Guglielmo Ramieri, Maximilian Goetzinger, Gian Battista Bottini, Ali O. Rizvi, Sean Laverick, Predrag Knežević, Emil Dediol, Mario Kordić, Anamaria Sivrić, Dimitra Ganasouli, Stylianos N. Zanakis, Drago Jelovac, Vitomir S. Konstantinovic, Anže Birk, Aleš Vesnaver, Alessandro Rabufetti, Paolo Scolozzi, Fatma Eriş Derkuş, Utku Nezih Yilmaz, Constantinus Politis, and Kathia Dubron
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internal fixation device ,jaw fixation techniques ,mandibular fractures ,multi-centric study ,open fracture reduction ,prospective study ,Oral Surgery - Abstract
Purpose: Intraoperative stabilisation of bony fragments with maxillo-mandibular fixation (MMF) is an essential step in the surgical treatment of mandibular fractures that are treated with open reduction and internal fixation (ORIF). The MMF can be performed with or without wire-based methods, rigid or manual MMF, respectively. The aim of this study was to compare the use of manual versus rigid MMF, in terms of occlusal outcomes and infective complications. Materials and methods: This multi-centric prospective study involved 12 European maxillofacial centres and included adult patients (age ≥16 years) with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate or partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, modality of intraoperative MMF (manual or rigid), outcome (minor/major malocclusions and infective complications) and revision surgeries. The main outcome was malocclusion at 6 weeks after surgery. Results: Between May 1, 2021 and April 30, 2022, 319 patients-257 males and 62 females (median age, 28 years)-with mandibular fractures (185 single, 116 double and 18 triple fractures) were hospitalised and treated with ORIF. Intraoperative MMF was performed manually on 112 (35%) patients and with rigid MMF on 207 (65%) patients. The study variables did not differ significantly between the two groups, except for age. Minor occlusion disturbances were observed in 4 (3.6%) patients in the manual MMF group and in 10 (4.8%) patients in the rigid MMF group (p > .05). In the rigid MMF group, only one case of major malocclusion required a revision surgery. Infective complications involved 3.6% and 5.8% of patients in the manual and rigid MMF group, respectively (p > .05). Conclusion: Intraoperative MMF was performed manually in nearly one third of the patients, with wide variability among the centres and no difference observed in terms of number, site and displacement of fractures. No significant difference was found in terms of postoperative malocclusion among patients treated with manual or rigid MMF. This suggests that both techniques were equally effective in providing intraoperative MMF.
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- 2023
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8. Characteristics and age‐related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study
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Ignasi Segura‐Palleres, Federica Sobrero, Fabio Roccia, Luis Fernando de Oliveira Gorla, Valfrido Antonio Pereira‐Filho, Daniel Gallafassi, Leonardo Perez Faverani, Irene Romeo, Alessandro Bojino, Chiara Copelli, Francesc Duran‐Valles, Coro Bescos, Dimitra Ganasouli, Stelios N. Zanakis, Ahmed Gaber Hassanein, Haider Alalawy, Mohammed Kamel, Sahand Samieirad, Mehul Rajesh Jaisani, Sajjad Abdur Rahman, Tabishur Rahman, Timothy Aladelusi, Kirsten Carlaw, Peter Aquilina, Euan Rae, Sean Laverick, Maximilian Goetzinger, Gian Battista Bottini, University of Turin, Universidade Estadual Paulista (UNESP), Hospital Universitario Vall D’Hebron, Hippocratio General Hospital, Sohag University, Gazi Alhariri Hospital, Mashhad University of Medical Sciences, Aligarh Muslim University, University of Ibadan, Nepean Hospital, University of Dundee, Paracelsus Medical University, Institut Català de la Salut, [Segura-Palleres I, Sobrero F, Roccia F] Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy. [de Oliveira Gorla LF, Pereira-Filho VA] Department Diagnosis and Surgery, Araraquara Dental School, São Paulo State University, UNESP, São Paulo, Brazil. [Gallafassi D] Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, São Paulo, Brazil. [Duran-Valles F, Bescos C] Servei de Cirurgia Oral i Maxil·lofacial, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Adult ,Male ,Environment and Public Health::Public Health::Accidents::Accidents, Traffic [HEALTH CARE] ,Adolescent ,personas::Grupos de Edad::niño [DENOMINACIONES DE GRUPOS] ,heridas y lesiones::fracturas óseas::fracturas craneales::fracturas maxilomandibulares::heridas y lesiones::fracturas mandibulares [ENFERMEDADES] ,Wounds and Injuries::Fractures, Bone::Skull Fractures::Jaw Fractures::Wounds and Injuries::Mandibular Fractures [DISEASES] ,children ,Mandibular Fractures ,Humans ,Prospective Studies ,Child ,Mandíbula - Fractures ,Retrospective Studies ,Skull Fractures ,Accidents, Traffic ,Infant, Newborn ,Infant ,Persons::Age Groups::Child [NAMED GROUPS] ,ambiente y salud pública::salud pública::accidentes::accidentes de tráfico [ATENCIÓN DE SALUD] ,prospective ,adolescent ,epidemiology ,maxillofacial fractures ,multicentric ,Circulació - Accidents ,Child, Preschool ,Female ,Maxillofacial Injuries ,Oral Surgery ,Infants - Abstract
Made available in DSpace on 2022-04-29T08:39:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Background/Aims: Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1-year period. Methods: The following data were collected: age (preschool [0–6 years], school age [7–12 years], and adolescent [13–18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. Results: Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p
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- 2022
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9. European multicenter prospective analysis of the use of maxillomandibular fixation for mandibular fractures treated with open reduction and internal fixation
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Fabio Roccia, Federica Sobrero, Elisa Raveggi, Alessandro Rabufetti, Paolo Scolozzi, Kathia Dubron, Constantinus Politis, Dimitra Ganasouli, Stylianos N. Zanakis, Drago Jelovac, Vitomir S. Konstantinovic, Anže Birk, Aleš Vesnaver, Predrag Knežević, Emil Dediol, Mario Kordić, Anamaria Sivrić, Ali O. Rizvi, Sean Laverick, Nil Valentines Vilaplana, Antonio Mari Roig, Fatma Eriş Derkuş, Utku Nezih Yilmaz, Maximilian Goetzinger, Gian Battista Bottini, and Guglielmo Ramieri
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Otorhinolaryngology ,Surgery ,Oral Surgery - Abstract
The goal of mandibular fracture treatment is to restore static and dynamic occlusal functions. Open reduction and internal fixation (ORIF) of these fractures can be associated with an intraoperative and/or postoperative maxillo-mandibular fixation (MMF). The aim of this study was to analyse the use of perioperative MMF and its effects on occlusal outcomes in the management of mandibular fractures.This multicentric prospective study included adult patients with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate, partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, type of ORIF (rigid, non-rigid or mixed), thickness and number of plates, modality of intraoperative MMF (arch bars, self-tapping and self-drilling screws [STSDSs], manual, other) and duration of postoperative MMF. The primary outcome was malocclusion at 6 weeks and 3 months. Statistical analyses were performed with Fisher's exact test or chi-square test, as appropriate.Between 1 May 2021 and 30 April 2022, 336 patients, 264 males and 72 females (median age, 28 years) with mandibular fractures (194 single, 124 double and 18 triple fractures) were hospitalized. Intraoperative MMF was performed in all patients. Osteosynthesis was rigid in 75% of single fractures, and rigid or mixed in 85% and 100% of double and triple fractures, respectively. Excluding patients who underwent manual reduction, postoperative MMF (median duration, 3 weeks) was performed in 140 (64%) patients, without differences by type or number of fractures (p0.05). No significant difference was found in the incidence of malocclusion in patients with postoperative MMF (5%, 95% confidence interval [CI], 2-10%) compared to those without (4%; 95% IC, 1-11%) (p0.05).Postoperative MMF was performed in more than half of the patients despite adequate fracture osteosynthesis, with wide variability among centers. No evidence of a reduction in the incidence of postoperative malocclusion in patients treated with postoperative MMF was found.
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- 2022
10. Different Presentation and Outcomes in the Surgical Treatment of Advanced MRONJ in Oncological and Nononcological Patients Taking or Not Corticosteroid Therapy
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Paolo Garzino Demo, Alessandro Bojino, Fabio Roccia, Maria Chiara Malandrino, Stefan Cocis, and Guglielmo Ramieri
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Article Subject ,General Immunology and Microbiology ,Medicine ,General Medicine ,General Biochemistry, Genetics and Molecular Biology - Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect caused by antiangiogenic antiresorptive drugs used to treat various oncological and non oncological diseases. The clinical and radiological characteristics of MRONJ depend on the type of causative drug, the time of administration, and its dosage. Proven systemic risk factors like anemia, uncontrolled diabetes, corticosteroid therapy, and chemotherapy in neoplastic diseases (e.g., high doses of methotrexate up to 30 mg daily) significantly increase the chances of acquiring MRONJ. The risk factors themselves can affect treatment outcomes. Although the main scientific societies have recently disseminated good practice rules on the patient’s prevention, diagnosis, and management, there are still no guidelines on shared therapeutic strategies. In general, if conservative treatment fails, surgical treatment is considered, including local debridement, osteoplasty, and marginal or segmental osteotomy. In literature, cohorts of heterogeneous patients with MRONJ have been analyzed for a long time, resulting in a lack of uniformity of information and difficulties interpreting the data. According to the American Association of Oral and Maxillofacial Surgeons criteria, this retrospective study evaluates the surgical treatment outcomes of 64 patients with stage II-III MRONJ, evaluated at the Department of Maxillofacial Surgery of the University of Turin (Italy). The first objective of this retrospective study is to evaluate treatment results for stages II-III in all cases; the second objective is to evaluate the same results by dividing the sample into different cohorts of patients: first, based on the underlying pathology, i.e., oncological and non oncological, and secondly, based on the drug or combination of drugs they took.
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- 2021
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11. A Multicentric Prospective Study on Maxillofacial Trauma Due to Road Traffic Accidents: The World Oral and Maxillofacial Trauma Project
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Irene Romeo, Fabio Roccia, Timothy Aladelusi, Euan Rae, Sean Laverick, Dimitra Ganasouli, Stelios N. Zanakis, Luis Fernando de Oliveira Gorla, Valfrido Antonio Pereira-Filho, Daniel Gallafassi, Leonardo Perez Faverani, Haider Alalawy, Mohammed Kamel, Sahand Samieirad, Mehul Raiesh Jaisani, Sajjad Abdur Rahman, Tabishur Rahman, Maximilian Goetzinger, Gian Battista Bottini, Kirsten Carlaw, Peter Aquilina, Francesc Duran-Valles, Coro Bescos, and Ahmed Gaber Hassanein
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Male ,Injury Severity Score ,Otorhinolaryngology ,Protective Devices ,Accidents, Traffic ,Humans ,Surgery ,Female ,Maxillofacial Injuries ,General Medicine ,Prospective Studies ,Retrospective Studies - Abstract
The purpose of this prospective multicenter study was to analyze the epidemiology, patterns, and management of maxillofacial fractures due to road traffic accidents (RTAs) worldwide.Between Monday September 30, 2019 and Sunday October 4, 2020,1066 patients with RTAs related fractures were admitted to 14 maxillofacial surgery departments. The following data were analyzed: age, gender, mechanism of injury, alcohol or drug abuse at the time of trauma, maxillofacial fracture site, facial injury severity scale (FISS) score, associated injuries, day and month of trauma, time of treatment, type of treatment and length of hospital stay. Data were analyzed using bivaried and multivaried statistical analysis.Eight hundred seventy patients were male, and 196 were female. The most common mechanism of injury was motorcycle accidents (48%). More than half of the patients had fractures of the middle third of the maxillofacial skeleton. In total, 59% of the study sample underwent open reduction internal fixation. The median facial injury severity scale (3 points) and the medial hospital stay (3 days) were significantly lower in patients with seatbelts and helmet (P 0.001).This first prospective, multicenter epidemiological study shows that motorcycle accidents are the leading cause of RTAs related fractures, mostly in young males. Particularly in Australia and Europe, the incidence of RTAs was significantly lower. Moreover, this study found that the severity of maxillofacial lesions was significantly higher in patients without safety devices, with consequent longer hospital stay demonstrating the efficacy of road safety policies in preventing maxillofacial injury.
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- 2022
12. Characteristics and surgical management of pure trapdoor fracture of the orbital floor in adults: a 15-year review
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Ylenia Gugliotta, Fabio Roccia, Paolo Garzino Demo, and Maria Beatrice Rossi
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Otorhinolaryngology ,Surgery ,Oral Surgery - Abstract
Purpose This retrospective study aims to define the optimal timing of the surgical treatment of orbital floor trapdoor fractures (OFTFs) in adults according to clinical and radiological findings. Methods From January 2006 to December 2020, 382 patients with isolated orbital floor fracture were admitted to the Division of Maxillofacial Surgery of Turin, Italy. The criteria for inclusion were age ≥ 16 years, preoperative computed tomography showing a linear (1a) or medial hinge fracture (1b), diplopia, and 6 months of follow-up data. Aetiology and mechanism of injury, presence of post-traumatic enophthalmos and oculocardiac reflex, time between trauma occurrence and surgery [stratified as 96 h (late treatment)], days of hospitalisation, and clinical outcomes were examinated. Results Twenty-four patients (18 males; mean age, 23.2 years) presented with OFTFs. The most common cause was sport injury (50%). Type 1a fracture was observed in eight patients (mean age, 19.5 years), type 1b fracture in 16 patients (mean age, 23.6 years). Urgent, early, and late treatments were performed in eight patients each. The mean time between trauma occurrence and surgery was 3,8 days (range: 0–17 days). Resolution of diplopia was observed 1 week after surgery in 10 patients, 1 month in 12. Diplopia persisted in 2 patient, both treated > 96 h after trauma. Conclusion Although the number of patients was too small to define a standard protocol, the authors recommend early treatment of adult OFTFs to promote complete resolution of diplopia.
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- 2022
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13. Letter to the Editor: a lesson from 'European multicenter prospective analysis of the use of maxillomandibular fixation for mandibular fractures treated with open reduction and internal fixation'
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Federica Sobrero, Fabio Roccia, Emanuele Zavattero, and Elisa Raveggi
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Otorhinolaryngology ,Surgery ,Oral Surgery - Published
- 2023
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14. Surgical Management of Mandibular Angle Fractures: Does the Extraction of the Third Molar Lead to a Change in the Fixation Pattern? A European Multicenter Survey
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Ignasi Segura-Pallerès, Francesc Duran-Valles, Gian Battista Bottini, Fabio Roccia, Stefan Cocis, Vitomir S. Konstantinovic, Petko Petrov, and Stylianos N. Zanakis
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Molar ,European level ,medicine.medical_treatment ,Mandibular angle ,Fracture Fixation, Internal ,03 medical and health sciences ,0302 clinical medicine ,Mandibular Fractures ,Humans ,Medicine ,Internal fixation ,Lead (electronics) ,Reduction (orthopedic surgery) ,Retrospective Studies ,Fixation (histology) ,Orthodontics ,business.industry ,030206 dentistry ,Treatment Outcome ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Multicenter survey ,Molar, Third ,Surgery ,Oral Surgery ,business ,Bone Plates - Abstract
Purpose The authors conducted a retrospective, multicenter study to investigate the differences in the fixation patterns, in terms of number and thickness of plates, between patients in whom a third molar (3M) was maintained or removed in the line of mandibular angle fractures. Materials and methods The study was conducted in 6 European level I and II maxillofacial trauma centers. Data were collected on patients ≥ 16 years of age who underwent open reduction internal fixation (ORIF) for mandibular angle fractures (MAF) from 2008 to 2018, in whom a 3M in the fracture line was present and who had a follow-up duration of 6 months. The study population was divided into 2 groups: patients treated with ORIF in whom the 3M was maintained (group 1) and those treated with ORIF in whom the 3M was extracted (group 2) during treatment. The 2 groups were compared for differences in the internal fixation pattern, specifically in terms of the number and thickness of the plates. Results A total of 749 patients with 774 MAF were collected. A total of 1,050 plates were placed: 849 were ≤ 1.4 mm thick (80.9%) and 201 plates ≥ 1.5 mm thick (19.1%). 548 patients were treated with ORIF and 3M maintained (group 1), and 201 treated with ORIF and 3M extracted (group 2). Statistically significant differences were seen in the number of ≤1.4 mm plates between the 2 groups for single undisplaced/displaced MAF(P value ≤ 0.5) and for undisplaced/displaced angle + parasymphysis/body fractures (P-value ≤ 0.5). Conclusions Analyses of data collected from 6 European maxillofacial centers indicated that the majority of surgeons of our sample perceived the MAF as being more unstable when removing the 3M during ORIF leading them to perform a rigid fixation in the angular region.
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- 2021
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15. Comprehensive analyses of maxillofacial fractures due to non‐professional sports activities in Italy
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Fabio Roccia, Elena Giaccone, Alessandro Bojino, and Stefan Cocis
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Time to treatment ,Return to sport ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Internal fixation ,Sports activity ,Contraindication ,Aged ,Retrospective Studies ,Skull Fractures ,business.industry ,General surgery ,030229 sport sciences ,030206 dentistry ,Middle Aged ,Italy ,Facial injury ,Mechanism of injury ,Athletic Injuries ,Female ,Maxillofacial Injuries ,Oral Surgery ,business ,human activities ,After treatment - Abstract
BACKGROUND/AIM Sports activities have become increasingly popular among amateurs and this has led to an increase in maxillofacial fractures. The aim of this study was to investigate the management of amateur sport-related maxillofacial fractures and appropriate preventive measures. METHODS A trauma database was used to analyze 3231 patients with maxillofacial fractures admitted to the Maxillofacial Surgery Division of Citta della Salute e della Scienza Hospital, Turin, Italy, from January 2001 to December 2019. Only patients with non-professional sports-related maxillofacial fractures were included. The following data were collected: age, gender, type of sport, mechanisms of injury, sites of fracture, Facial Injury Severity Scale, associated injuries, month of trauma, time to treatment, treatment, length of stay, and interval before return to sport. RESULTS There were 432 patients, 378 males and 54 females, with a mean age of 29.2 (5-76 years). Sport-related maxillofacial fractures' relative percent ranged from 11.1% in 2001 to 17.5% in 2019. Soccer was the most common cause of sport-related maxillofacial fractures (54.2%), and impact with a player/opponent was the main mechanism of injury (72%). An intentional violent act (player hit by a fist) was the cause of fracture in 8.5% of the soccer-related injuries. Fractures of the middle third of the face occurred in 61.2% of patients. Maxillofacial fractures were treated within 24 h in 25% of patients. There were 343 out of 412 patients who received open reduction and internal fixation (mean length of hospital stay: 3.7 days). There was no contraindication to resuming sport activities at 30/40 days after treatment, except for combat sports. CONCLUSIONS This study provided further evidence of a relative increase in sports-related maxillofacial fractures. Soccer is related to the majority of sport maxillofacial fractures. Adherence to the rules is necessary to limit violent acts that cause such injuries. In non-professional players, resumption of the full activity is allowed after 40 days for non-combat sports.
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- 2020
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16. Intraoral approach for the excision of a submandibular epidermoid cyst
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Elisa RAVEGGI, Lucia MONTANARO, Fabio ROCCIA, and Paolo GARZINO-DEMO
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- 2022
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17. A multicentric prospective analysis of maxillofacial trauma in the elderly population
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Alessandro Bojino, Fabio Roccia, Kirsten Carlaw, Peter Aquilina, Euan Rae, Sean Laverick, Irene Romeo, Oreste Iocca, Chiara Copelli, Federica Sobrero, Ignasi Segura‐Pallerès, Dimitra Ganasouli, Stelios N. Zanakis, Luis Fernando de Oliveira Gorla, Valfrido Antonio Pereira‐Filho, Daniel Gallafassi, Leonardo Perez Faverani, Haider Alalawy, Mohammed Kamel, Sahand Samieirad, Mehul Rajesh Jaisani, Sajjad Abdur Rahman, Tabishur Rahman, Timothy Aladelusi, Ahmed Gaber Hassanein, Francesc Duran‐Valles, Coro Bescos, Maximilian Goetzinger, Gian Battista Bottini, University of Turin, Nepean Hospital, University of Dundee, Hippokration General Hospital, Universidade Estadual Paulista (UNESP), Medical City, Mashhad University of Medical Sciences, B.P. Koirala Institute of Health Sciences, Aligarh Muslim University, University of Ibadan, Sohag University, Hospital Universitario Vall D'Hebron, and Paracelsus Medical University Salzburg
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Male ,Skull Fractures ,elderly ,epidemiology ,maxillofacial fractures ,multicentric ,prospective ,Accidents, Traffic ,Australia ,Fractures, Bone ,Humans ,Female ,Maxillofacial Injuries ,Prospective Studies ,Oral Surgery ,Aged ,Retrospective Studies - Abstract
Made available in DSpace on 2022-04-29T08:39:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Background/Aims: The growth of the global elderly population will lead to an increase in traumatic injuries in this group, including those affecting the maxillofacial area, with a heavier load on health systems. The aim of this multicentric prospective study was to understand and evaluate the incidences, causes and patterns of oral and maxillofacial injuries in patients aged over 60 years admitted to 14 maxillofacial surgical departments around the world. Methods: The following data were collected: gender, cause and mechanism of maxillofacial fracture, alcohol and drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment and length of hospitalization. Statistical analyses were performed using non-parametric and association tests, as well as linear regression. Results: Between 30 September 2019 and 4 October 2020, 348 out of 2387 patients (14.6%), 197 men and 151 women (ratio 1.3:1; mean age 72.7 years), were hospitalized. The main causes of the maxillofacial fractures were falls (66.4%), followed by road traffic accidents (21.5%) and assaults (5.2%). Of the 472 maxillofacial fractures, 69.7% were in the middle third of the face, 28% in the lower third and 2.3% in the upper third. Patients with middle third fractures were on average 4.2 years older than patients with lower third fractures (95% CI 1.2–7.2). Statistical analysis showed that women were more involved in fall-related trauma compared with males (p
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- 2022
18. Surgical Management of the Peripheral Osteoma of the Zygomatic Arch: A Case Report and Literature Review
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Claudia Borbon, Fabio Roccia, Umberto Autorino, Giovanni Gerbino, and Maria Chiara Malandrino
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medicine.medical_specialty ,040301 veterinary sciences ,lcsh:Surgery ,Case Report ,0403 veterinary science ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Pharmacology (medical) ,Osteoma ,Orthodontics ,business.industry ,Mandible ,lcsh:RD1-811 ,030206 dentistry ,04 agricultural and veterinary sciences ,medicine.disease ,Peripheral ,Surgery ,body regions ,Right zygomatic arch ,medicine.anatomical_structure ,Paranasal sinuses ,Osteogenic Neoplasm ,Zygomatic arch ,business ,Cancellous bone - Abstract
An osteoma is a benign, slow-growing, osteogenic neoplasm with a low recurrence rate that is typically characterized by the proliferation of a compact or cancellous bone. It can be peripheral, central, or extraskeletal. Usually asymptomatic, peripheral osteomas in the maxillofacial region commonly arise in the paranasal sinuses and mandible and rarely occur in the zygomatic arch, with only six previously documented cases in the literature. Here, we present the management of a solitary peripheral osteoma of the right zygomatic arch in a 72-year-old woman and a review of the literature.
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- 2019
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19. Maxillofacial Injuries Due to Traffic Accidents
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Fabio Roccia, Emanuele Zavattero, Guglielmo Ramieri, Jacqueline Pascale Sotong, and Matteo Savoini
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medicine.medical_specialty ,Fracture site ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,Humans ,Medicine ,030223 otorhinolaryngology ,Road traffic ,Retrospective Studies ,business.industry ,Accidents, Traffic ,Alcohol and drug ,Retrospective cohort study ,030206 dentistry ,General Medicine ,Length of Stay ,Italy ,Otorhinolaryngology ,Mechanism of injury ,Facial injury ,Emergency medicine ,Maxillofacial Injuries ,Surgery ,business ,Hospital stay - Abstract
Purpose The purpose of this retrospective study was to analyze the epidemiology, patterns, and management of maxillofacial due to road traffic accidents over a 17-year period. Methods Between January 2001 and December 2017, 2924 patients with maxillofacial fractures were admitted to the Division of Maxillofacial Surgery, Turin, Italy.The following data were analyzed: age, gender, data of the trauma, alcohol and drug abuse, mechanism of injury, fracture site, facial injury severity scale, associated injuries, type of treatment, and length of hospital stay. Results Of the 605 patients included in the study, 419 were male and 186 were female (ratio, 2.2:1). The most common mechanism of injury was car accidents (62.6%).More than half of the patients had fractures of the middle third of the maxillofacial skeleton.Associated injuries were detected in 172 (45.5%) patients. In total 5.3% of patients did not undergo surgery. The average hospital stay was 7.3 days. Conclusions This study shows an important reduction in maxillofacial fractures following road traffic accidents since the turn of the new millennium. At least in north-western Italy, road safety policies implemented in the last 30 years seem to have affected the behavior of motorists and motorcyclists.
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- 2019
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20. Difference in outcomes in surgical treatment of stage II-II MRONJ in oncological and non-oncological patients
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Alessandro Bojino, Guglielmo Ramieri, Maria Chiara Malandrino, Fabio Roccia, and Paolo Garzino Demo
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medicine.medical_specialty ,Osteoplasty ,Side effect ,business.industry ,General surgery ,General Engineering ,Retrospective cohort study ,Stage ii ,medicine.disease ,Segmental osteotomy ,medicine ,Stage (cooking) ,Osteonecrosis of the jaw ,business ,Surgical treatment - Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect caused by antiresorptive antiangiogenic medication for different pathologies. Although the main factors that seem to increase the risk of ONJ have been identified and the main scientific societies have recently disclosed rules of good behaviour regarding prevention, diagnosis and patient management, there are still no guidelines on therapeutic strategies to be adopted. In general, if conservative treatment fails, surgical treatment is considered, including local debridement, osteoplasty, and marginal or segmental osteotomy. To date, in literature, cohorts of heterogeneous patients with MRONJ have been analysed for a long time, with a lack of uniformity in information and difficulties in interpreting data. This retrospective study evaluates the results of surgical treatment of 62 patients with stage II-III of MRONJ according to the American Association of Oral and Maxillofacial Surgeons criteria, evaluated at the Department of Maxillofacial Surgery, in the University of Turin (Italy), by subdividing patients into different cohorts firstly according to the primary pathology, i,e. oncological and non-oncological, and secondly, according to the drug or combination of drugs taken.
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- 2021
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21. Calcifying epithelial odontogenic tumor of the mandible mistaken as an odontogenic cyst
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Irene Romeo, Claudia Maugeri, Enrico Costantino Falco, and Fabio Roccia
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Pathology ,medicine.medical_specialty ,Odontogenic cyst ,business.industry ,Mandible ,Medicine ,business ,medicine.disease ,Calcifying epithelial odontogenic tumor - Published
- 2021
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22. Aggressive angiolymphoid hyperplasia with eosinophilia of the tongue: A case report and review of the literature
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Paolo Garzino Demo, Federica Grieco, Fabio Volpe, Fabio Roccia, and Enrico Costantino Falco
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medicine.medical_specialty ,business.industry ,lcsh:Surgery ,lcsh:RD1-811 ,medicine.disease ,Dermatology ,medicine.anatomical_structure ,Otorhinolaryngology ,Tongue ,Medicine ,Surgery ,Oral Surgery ,business ,Angiolymphoid hyperplasia with eosinophilia - Published
- 2020
23. Surgical Management of Bilateral Mandibular Angle Fractures With a Third Molar in Line of Fracture: A European Multicenter Survey
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Ignasi Segura-Pallerès, Coro Bescos Atin, Angel G. Bakardjiev, Drago Jelovac, Fabio Roccia, Maximilian Goetzinger, Stefan Cocis, and Dimitra Ganasouli
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Molar ,Adult ,Male ,Adolescent ,medicine.medical_treatment ,Mandibular angle ,03 medical and health sciences ,Fracture Fixation, Internal ,Young Adult ,0302 clinical medicine ,Mandibular Fractures ,Surveys and Questionnaires ,Fracture fixation ,medicine ,Internal fixation ,Humans ,Reduction (orthopedic surgery) ,Aged ,Retrospective Studies ,Orthodontics ,Aged, 80 and over ,Osteosynthesis ,business.industry ,030206 dentistry ,Middle Aged ,Europe ,Treatment Outcome ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Multicenter survey ,Fracture (geology) ,Surgery ,Female ,Molar, Third ,Oral Surgery ,business ,Bone Plates - Abstract
Purpose The aim of this survey was to investigate the surgical management of bilateral mandibular angle fracture (BMAF) in Europe. Methods Data were collected from 2008 to 2018 on patients ≥ 16 years of age who underwent open reduction internal fixation (ORIF) for BMAF with a third molar in the fracture line. The study was conducted at 6 European trauma centers. The following data were recorded: sex, age, cause of the fracture, type of fracture (nondisplaced, displaced, comminuted), type of approach (intraoral, transbuccal, or extraoral), thickness of the plate (≤1.4 mm or ≥1.5 mm), number of plates, cause of plate removal, and third molar extraction status. Results 25 patients with BMAF (24 males, 1 female, 17 to 83 years old [mean: 28.2 years]) were collected. The main cause of BMAF was assault, and the main surgical approach was intraoral. The most common types of BMAF were displaced + undisplaced (11 patients), displaced + displaced (7 patients), undisplaced + undisplaced (6 patients), and comminuted + comminuted (1 patient). Osteosynthesis was performed with 2 ≤1.4 mm plates on 1 angular fracture and 1 ≤1.4 mm plate on the other fracture in 11 patients, 1 ≤1.4 mm plate on both angular fractures in 6 patients, 1 ≥1.5 mm plate on both fractures in 5 patients, and 2 ≤1.4 mm plates on both fractures in the remaining 3 patients. Out of 25 patients with BMAF, 7 third molars were extracted during ORIF. Among these patients, angular fracture fixation was performed in 3 cases with 1 ≥1.5 mm plate and in 4 patients with 2 ≤1.4 mm plates. Conclusions This retrospective multicenter survey indicates a trend of treating with open reduction and rigid internal fixation at least 1 angular fracture of BMAF and those cases requiring extraction of the third molar in the line of fracture.
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- 2020
24. EURMAT project: the significance of multidisciplinary studies to analyze the changing characteristics of maxillofacial trauma
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Fabio Roccia and Emanuele Zavattero
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Multidisciplinary approach ,business.industry ,Medicine ,Medical emergency ,business ,medicine.disease - Published
- 2019
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25. Bilateral body mandibular fractures:comparison between dentate and edentulous patients
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Emanuele Zavattero, Matteo Savoini, Stefan Cocis, Fabio Roccia, and Giovanni Gerbino
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business.industry ,Mandibular fractures - Mouth ,edentulous - Dentition ,Mandibular fractures - Mouth, edentulous - Dentition ,Medicine ,business - Published
- 2019
26. Epithelioid Hemangioma of the Face
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Luca Sedran, Mila Bonaso, Fabio Roccia, and Arianna Mettus
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Nose Neoplasms ,Eyelid Neoplasms ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Nasal region ,0502 economics and business ,medicine ,Medical imaging ,Humans ,Embolization ,Epithelioid Hemangioma ,Arterial trunk ,medicine.diagnostic_test ,business.industry ,05 social sciences ,Angiography ,General Medicine ,Middle Aged ,Embolization, Therapeutic ,Otorhinolaryngology ,030221 ophthalmology & optometry ,Rare Lesion ,Surgery ,Radiology ,medicine.symptom ,Neoplasm Recurrence, Local ,business ,Hemangioma ,Tomography, X-Ray Computed ,050203 business & management - Abstract
An epithelioid hemangioma is a very rare lesion arising from vascular structures. We encountered 2 cases in atypical locations, one in the orbital and the other in the nasal region. We performed preoperative angiography in addition to the diagnostic imaging recommended in the literature. Angiography highlighted the lesions well, and in one case, it was possible to embolize the arterial trunk of a high-flow lesion. Angiography underscored how such lesions may differ from the vascular perspective, emphasizing the importance of histology in correct diagnosis. Management of both hemangiomas yielded good functional and cosmetic outcomes with no disease recurrence.
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- 2018
27. Management of Atrophic Mandibular Fractures: An Italian Multicentric Retrospective Study
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Stefan Cocis, Gabriele Canzi, Fabio Roccia, Giovanni Gerbino, Davide Sozzi, Giorgio Novelli, Gerbino, G, Cocis, S, Roccia, F, Novelli, G, Canzi, G, and Sozzi, D
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Adult ,Male ,Weakness ,Mandibular fracture ,Atrophic mandible ,Edentulous ,Load-bearing plate ,Surgery ,Oral Surgery ,Otorhinolaryngology2734 Pathology and Forensic Medicine ,medicine.medical_treatment ,Bone healing ,Bone grafting ,03 medical and health sciences ,Fixation (surgical) ,Fracture Fixation, Internal ,0302 clinical medicine ,Atrophy ,Postoperative Complications ,Trauma Centers ,Mandibular Fractures ,Medicine ,Humans ,Edentulou ,Aged ,Retrospective Studies ,Orthodontics ,Aged, 80 and over ,business.industry ,Retrospective cohort study ,030206 dentistry ,Middle Aged ,medicine.disease ,Facial nerve ,Treatment Outcome ,Otorhinolaryngology ,Italy ,030220 oncology & carcinogenesis ,Female ,medicine.symptom ,business ,Bone Plates - Abstract
Purpose: The aim of this multicentric study was to retrospectively evaluate the surgical outcome of atrophic mandible fractures treated with open reduction and rigid fixation (ORIF), using load-bearing plates. Materials and methods: 55 patients from three trauma centers were retrieved for the study. Inclusion criteria were: edentulous patients with mandibular body fractures; mandibular body thickness
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- 2018
28. European Maxillofacial Trauma (EURMAT) project: a multicentre and prospective study
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Even Mjøen, Peter Gordon, Per Skjelbred, Fabio Roccia, Vedran Uglešić, Emanuele Zavattero, Tiia Tamme, Aleš Vesnaver, Nabeel Bhatti, Vladislav A. Malanchuk, Njål Lekven, Guillaume Mouallem, Stephanie Akermann, Sigbjørn Løes, Pål Galteland, Pierre Corre, Amar Kanzaria, Žiga Kovačič, Jonny Stephens, Sean Laverick, Petia Pechalova, Carine Koudougou, K. Hakki Karagozoglu, Milan Petrovic, Paolo Boffano, Vitomir S. Konstantinovic, Simon Holmes, Tymour Forouzanfar, Andrey Kopchak, Emil Dediol, Sofie C. Kommers, Angel G. Bakardjiev, MKA VUmc (ORM, ACTA), Maxillofacial Surgery (VUmc), Oral and Maxillofacial Surgery / Oral Pathology, and MOVE Research Institute
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Male ,Epidemiology ,Poison control ,Mandible ,Facial fracture ,Occupational safety and health ,Injury Severity Score ,Mandibular Fractures ,Prospective Studies ,Aetiology ,Prospective cohort study ,Zygomatic Fractures ,Accidents, Traffic ,Age Factors ,Middle Aged ,Cause ,3. Good health ,Europe ,Athletic Injuries ,Oral and maxillofacial surgery ,Female ,Seasons ,Oral Surgery ,Adult ,medicine.medical_specialty ,Mandibular fracture ,Violence ,aetiology ,assaults ,cause ,epidemiology ,facial fracture ,mandible ,Maxillary Fractures ,Sex Factors ,SDG 3 - Good Health and Well-being ,Injury prevention ,medicine ,Humans ,Orbital Fractures ,Skull Fractures ,business.industry ,General surgery ,Mandibular Condyle ,Assaults ,Length of Stay ,medicine.disease ,Occupational Injuries ,Surgery ,Otorhinolaryngology ,Etiology ,Accidental Falls ,Maxillofacial Injuries ,business - Abstract
The purpose of this study was to analyse the demographics, causes and characteristics of maxillofacial fractures managed at several European departments of oral and maxillofacial surgery over one year. The following data were recorded: gender, age, aetiology, site of facial fractures, facial injury severity score, timing of intervention, length of hospital stay. Data for a total of 3396 patients (2655 males and 741 females) with 4155 fractures were recorded. The mean age differed from country to country, ranging between 29.9 and 43.9 years. Overall, the most frequent cause of injury was assault, which accounted for the injuries of 1309 patients; assaults and falls alternated as the most important aetiological factor in the various centres.The most frequently observed fracture involved the mandible with 1743 fractures, followed by orbital-zygomatic-maxillary (OZM) fractures. Condylar fractures were the most commonly observed mandibular fracture.The results of the EURMAT collaboration confirm the changing trend in maxillofacial trauma epidemiology in Europe, with trauma cases caused by assaults and falls now outnumbering those due to road traffic accidents.The progressive ageing of the European population, in addition to strict road and work legislation may have been responsible for this change. Men are still the most frequent victims of maxillofacial injuries.
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- 2015
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29. Mandibular trauma treatment: a comparison of two protocols
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Paolo Boffano, Sofie C. Kommers, Fabio Roccia, Tymour Forouzanfar, Oral and Maxillofacial Surgery / Oral Pathology, MOVE Research Institute, MKA VUmc (ORM, ACTA), and Maxillofacial Surgery (VUmc)
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Adult ,Male ,Adolescent ,Mandibular fracture ,Dentistry ,Odontología ,Young Adult ,Clinical Protocols ,stomatognathic system ,Mandibular Fractures ,medicine ,Humans ,Child ,General Dentistry ,Aged ,Aged, 80 and over ,business.industry ,Research ,Trauma treatment ,Mandible ,Treatment options ,Middle Aged ,CIENCIAS MÉDICAS [UNESCO] ,medicine.disease ,Ciencias de la salud ,Otorhinolaryngology ,Multicenter study ,Child, Preschool ,UNESCO::CIENCIAS MÉDICAS ,Female ,Surgery ,Oral Surgery ,business - Abstract
Objectives: The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two centers in Turin, Italy and in Amsterdam, the Netherlands for ten years. Only patients who were admitted for mandibular fractures were considered for this study. Results: Between 2001 and 2010, a total of 752 patients were admitted at Turin hospital with a total of 1167 mandibular fractures not associated with further maxillofacial fractures, whereas 245 patients were admitted at Amsterdam hospital with a total of 434 mandibular fractures. At Amsterdam center, a total of 457 plates (1.5 - 2.7 mm) were used for the 434 mandibular fracture lines, whereas at Turin center 1232 plates (1.5 – 2.5 mm) were used for the management of the 1167 mandibular fracture lines. At Turin center, 190 patients were treated primarily with IMF, whereas 35 patients were treated with such treatment option at Amsterdam center. Conclusions: Current protocols for the management of mandibular fractures are quite efficient. It is difficult to obtain a uniform protocol, because of the difference of course of each occurring fracture and because of surgeons’ experiences and preferences. Several techniques can still be used for each peculiar fracture of the mandible.
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- 2015
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30. Comparison of the Outcomes of Complex Orbital Fracture Repair with and without a Surgical Navigation System: A Prospective Cohort Study with Historical Controls
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Fabio Roccia, Giovanni Gerbino, Guglielmo Ramieri, and Emanuele Zavattero
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Adult ,Male ,medicine.medical_specialty ,genetic structures ,Treatment outcome ,Cohort Studies ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Computer-Assisted ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Orbital Fracture ,Orbital Fractures ,Diplopia ,Female ,Middle Aged ,Treatment Outcome ,Surgery, Computer-Assisted ,Surgery ,Enophthalmos ,business.industry ,Navigation system ,030206 dentistry ,eye diseases ,030221 ophthalmology & optometry ,sense organs ,medicine.symptom ,business ,Cohort study - Abstract
In severe orbital fractures, restoration of orbital shape and volume is required to avoid diplopia and posttraumatic enophthalmos. The purpose of this study was to compare outcomes between navigation-aided and conventional techniques for complex unilateral orbital fractures using titanium mesh.The outcomes and the computed tomography-measured orbital volume of two groups of orbital complex unilateral reconstruction cases were compared. The study group consisted of a consecutive cohort of unilateral severe orbital fracture that underwent surgery with the aid of a Brainlab navigation system. A historical control group was composed of consecutive operations performed immediately before the beginning of navigation system use. A total of 55 operations were then identified and studied for patient characteristics, diplopia and globe position, preoperative and postoperative orbital volumes, complications, need for revision surgery, and the surgeon's performance.Postoperative diplopia severity was lower in the study group than in the control group. Orbital volume analysis showed that reconstructed orbital volume in the study group was closer to unaffected orbital volume compared with the control group. Significant orbital volume reduction in the reconstructed orbit could be achieved in the study group, and there was no significant reduction in the control group compared with the unaffected side. The globe projection was higher compared with the preoperative situation in the study group than in the control group. The navigational platform could also contribute to reduce the learning curve.This study demonstrated that computer-assisted techniques improve outcomes compared with conventional techniques.Therapeutic, III.
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- 2017
31. Surgical Management of Unusual Biangular Mandibular Fractures
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Umberto Autorino, Fabio Roccia, Stefan Cocis, and Chiara Corio
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Molar ,Orthodontics ,medicine.medical_specialty ,Surgical approach ,business.industry ,medicine.medical_treatment ,lcsh:Surgery ,Fracture line ,Dentistry ,Case Report ,lcsh:RD1-811 ,030206 dentistry ,Mandibular angle ,Fixation method ,Surgery ,03 medical and health sciences ,Fixation (surgical) ,0302 clinical medicine ,stomatognathic system ,Occlusion ,medicine ,Internal fixation ,Pharmacology (medical) ,030223 otorhinolaryngology ,business - Abstract
Bilateral mandibular angle fractures, while representing a rarity among mandibular fractures, are a huge challenge of complex management for the maxillofacial surgeon. There are still many open questions regarding the ideal management of such fractures, including the following: the removal of the third molar in the fracture line, the best surgical approach, and the fixation methods. In this report the authors present the case of 40-year-old man presenting with a bilateral mandibular angle fracture referred to the Maxillofacial Surgery Department of Turin. Open reduction and internal fixation has been made for both sides. The left side third molar was removed and the internal fixation was achieved through internal fixation with one miniplate according to Champy’s technique and transbuccal access for a 4-hole miniplate at the inferior border of the mandible. Right side third molar was not removed and fixation was achieved through intraoral access and positioning of a 4-hole miniplate along the external ridge according to Champy. An optimal reduction was achieved and a correct occlusion has been restored.
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- 2017
32. Fractures of the mandibular coronoid process: a two centres study
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Tymour Forouzanfar, Fabio Roccia, Sofie C. Kommers, Cesare Gallesio, Paolo Boffano, MKA VUmc (ORM, ACTA), Oral and Maxillofacial Surgery / Oral Pathology, MOVE Research Institute, and Maxillofacial Surgery (VUmc)
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Adult ,Male ,medicine.medical_treatment ,Joint Dislocations ,Dentistry ,Violence ,Young Adult ,Injury Severity Score ,Sex Factors ,SDG 3 - Good Health and Well-being ,Mandibular Fractures ,medicine ,Ankylosis ,Humans ,Internal fixation ,Crucial point ,Reduction (orthopedic surgery) ,Aged ,Netherlands ,Retrospective Studies ,Zygomatic Fractures ,business.industry ,Accidents, Traffic ,Age Factors ,Mean age ,Middle Aged ,medicine.disease ,Conservative treatment ,Coronoid process ,Italy ,Otorhinolaryngology ,Accidental Falls ,Female ,Surgery ,Oral Surgery ,business - Abstract
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.
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- 2014
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33. Inferior alveolar nerve injuries associated with mandibular fractures at risk: a two-center retrospective study
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Cesare Gallesio, Paolo Boffano, K.H. Karagozoglu, Tymour Forouzanfar, Fabio Roccia, Maxillofacial Surgery (VUmc), Oral and Maxillofacial Surgery / Oral Pathology, MOVE Research Institute, and MKA VUmc (ORM, ACTA)
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medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,Dentistry ,Retrospective cohort study ,Mandibular angle ,Inferior alveolar nerve ,Fracture displacement ,Article ,Surgery ,Otorhinolaryngology ,SDG 3 - Good Health and Well-being ,medicine ,Etiology ,University medical ,Oral Surgery ,business - Abstract
The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments—Department of Maxillofacial Surgery, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands, and Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy. Demographic, anatomic, and etiology variables were considered for each patient and statistically assessed in relation to the neurosensory IAN impairment. Statistically significant associations were found between IAN injury and fracture displacement ( p = 0.03), isolated mandibular fractures ( p = 0.01), and angle fractures ( p = 0.004). A statistically significant association was also found between IAN injury and assaults ( p = 0.03). Displaced isolated mandibular angle fractures could be considered at risk for increased incidence of IAN injury. Assaults seem to be the most important etiological factor that is responsible for IAN lesions.
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- 2014
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34. Orbital Trapdoor Fracture
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Giovanni Gerbino, Rodolfo Benech, Guglielmo Ramieri, Fabio Roccia, and Emanuele Zavattero
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Adult ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,Magnetic Resonance Imaging ,Nuclear magnetic resonance ,Otorhinolaryngology ,Oculomotor Muscles ,medicine ,Fracture (geology) ,Humans ,Female ,Surgery ,business ,Orbital Fractures ,Mechanism (sociology) - Abstract
We describe here a peculiar case of a 30-year-old woman presenting with an orbital trapdoor fracture. Preoperative and postoperative magnetic resonance images are provided to explain the mechanism of the injury.
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- 2015
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35. Late surgical treatment of posttraumatic mandibular deformity
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Cesare Gallesio, Fabio Roccia, Tymour Forouzanfar, Paolo Boffano, Maxillofacial Surgery (VUmc), MKA VUmc (ORM, ACTA), Oral and Maxillofacial Surgery / Oral Pathology, and MOVE Research Institute
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Adult ,Male ,Mandibular fracture ,medicine.medical_specialty ,Time Factors ,Asymmetry ,Malocclusion ,Mandibular trauma ,Osteotomy ,Treatment ,medicine.medical_treatment ,Bone healing ,Fracture Fixation, Internal ,stomatognathic system ,SDG 3 - Good Health and Well-being ,Mandibular Fractures ,Radiography, Panoramic ,Fracture fixation ,medicine ,Deformity ,Humans ,Malunion ,Surgical treatment ,Facial Injuries ,Orthodontics ,business.industry ,General Medicine ,Delayed treatment ,medicine.disease ,Surgery ,Otorhinolaryngology ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
Delays in treatment may complicate the treatment of mandibular trauma, leading to a bone healing in an abnormal position and to a posttraumatic mandibular deformity such as malunion, malocclusion, and asymmetry. All these features may make delayed treatment a challenging issue. Therefore, early reduction and fixation of displaced mandibular fractures is mandatory to allow precocious healing and return to the normal function. In this article, we describe a patient treated in our unit for a diagnosed posttraumatic malocclusion after lack of primary trauma treatment.
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- 2013
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36. Clinical outcomes of surgical management of anterior bilateral mandibular fractures
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Tymour Forouzanfar, Cesare Gallesio, B. van den Bergh, Fabio Roccia, Paolo Boffano, Oral and Maxillofacial Surgery / Oral Pathology, MOVE Research Institute, MKA VUmc (ORM, ACTA), and Maxillofacial Surgery (VUmc)
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Bone Screws ,Dentistry ,symbols.namesake ,Fracture Fixation, Internal ,SDG 3 - Good Health and Well-being ,Form and function ,Mandibular Fractures ,medicine ,Internal fixation ,Humans ,Fisher's exact test ,Reduction (orthopedic surgery) ,Aged ,Aged, 80 and over ,business.industry ,Mandible ,General Medicine ,Emergency department ,Length of Stay ,Middle Aged ,Surgery ,Treatment Outcome ,Otorhinolaryngology ,symbols ,Airway management ,Female ,Airway ,business ,Bone Plates - Abstract
Purpose: The aims of this study were to assess the clinical outcomes of patients with anterior bifocal mandibular fractures and to discuss the management of this peculiar type of trauma. Methods: From the systematic computer-assisted database that has continuously recorded patients hospitalized with maxillofacial fractures, only patients admitted with anterior bifocal bilateral mandibular fractures between 2001 and 2011 were considered. Patients were contacted, and they were invited to volunteer for a clinical follow-up examination. Statistical analysis was performed using the Fisher exact test, and P < 0.05 was considered statistically significant. Results: Forty dentate patients with anterior bifocal bilateral mandibular fractures (without the presence of further mandibular fractures) were included in the study. Nineteen patients with dislocated anterior segment underwent surgical intervention within 12 hours from hospital admission in the emergency department, whereas 21 patients with nondisplaced mandibular fractures were surgically treated in the elective operating room within 72 hours. Only 3 patients underwent tracheostomy. All patients underwent open reduction and internal fixation with 2.0- and 2.4-mm plates via intraoral approach, except for patients with submental or submandibular facial lacerations. Conclusions: Anterior bifocal bilateral mandibular fractures may involve a challenging management because they can compromise the upper airway. Accurate reduction and internal fixation of these fractures have been critical to restoring form and function of the mandible. The upper airway management and securing always take first, but a prompt surgical intervention of dislocated fractures avoids upper airways impairment.
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- 2013
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37. The surgical management of a leiomyosarcoma of the submandibular gland in a 95-year-old patient
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Sid Berrone, Emanuele Zavattero, Paola Campisi, Paolo Boffano, Emanuele Cassarino, Cesare Gallesio, and Fabio Roccia
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Leiomyosarcoma ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Biopsy, Fine-Needle ,Submandibular Gland ,Contrast Media ,Multimodal Imaging ,Disease-Free Survival ,Metastasis ,stomatognathic system ,Major Salivary Gland ,Biopsy ,medicine ,Humans ,General Dentistry ,Ultrasonography ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Soft tissue ,Neck dissection ,medicine.disease ,Submandibular gland ,Surgery ,Submandibular Gland Neoplasms ,Direct Extension ,medicine.anatomical_structure ,Otorhinolaryngology ,Positron-Emission Tomography ,Oral Surgery ,Tomography, X-Ray Computed ,business ,Follow-Up Studies - Abstract
Primary sarcomas of the major salivary glands are rare and appear to originate from undifferentiated pluripotential mesenchymal cells. They must be distinguished from malignant supporting tissue neoplasms that secondarily involve the glands by direct extension or metastasis. Multidisciplinary management of head and neck soft tissue sarcomas is still controversial. We report a case of leiomyosarcoma of the submandibular gland in a 95-year-old man who was treated with excision of the right submandibular gland, extended to the surrounding tissues, without neck dissection. The patient tolerated the treatment well. Twenty-four months after surgery, the patient was doing well without any evidence of locoregional or distant disease. Surgery is the cornerstone of the management of leiomyosarcomas of the salivary glands. Wide surgical excision with histologically proven tumor-free margins was an appropriate treatment that may guarantee prolonged survival.
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- 2011
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38. Rugby athletes’ awareness and compliance in the use of mouthguards in the North West of Italy
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Michele Boffano, Cesare Gallesio, Paolo Boffano, Riccardo Cignetti, Raimondo Piana, and Fabio Roccia
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medicine.medical_specialty ,Engineering ,business.product_category ,biology ,business.industry ,Athletes ,Poison control ,Human factors and ergonomics ,biology.organism_classification ,Suicide prevention ,Occupational safety and health ,North west ,Injury prevention ,Physical therapy ,medicine ,Mouthguard ,Oral Surgery ,business ,human activities - Abstract
– Background: The prevention of dental injuries during full-contact sports such as rugby is extremely important. Wearing a mouthguard can significantly reduce the frequency and severity of orofacial injuries, but it is not always used as athletes find it difficult to tolerate. The purpose of the present study was to determine the awareness and the extent of mouthguard use in a sample of young rugby athletes in the North West of Italy. Material and Methods: The athletes of four amateurs rugby teams based in the Province of Turin, Italy completed a questionnaire about playing history, current use and type of mouthguards, disturbs associated with mouthguard use, and general attitudes towards mouthguards. Results: Only 53.85% of the subjects reported wearing their mouthguard all the time both during training and games. The most commonly reported problem associated with using a mouthguard was the discomfort on speech, followed by difficulty in closing lips, adversely affected breathing, adversely affected swallowing and slipping sensation. A statistically significant association between patients
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- 2011
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39. Closed management by Ginestet hook elevator of v-shaped fractures of the zygomatic arch
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Tymour Forouzanfar, Cesare Gallesio, Paolo Boffano, K.H. Karagozoglu, Erik G. Salentijn, Fabio Roccia, Maxillofacial Surgery (VUmc), MKA VUmc (ORM, ACTA), Oral and Maxillofacial Surgery / Oral Pathology, and MOVE Research Institute
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Adult ,Male ,Elevator ,Hook ,Adolescent ,Esthetics ,Oral Surgical Procedures ,Young Adult ,Fracture Fixation ,medicine ,Humans ,Aged ,Zygomatic Fractures ,Orthodontics ,Zygoma ,business.industry ,General Medicine ,Equipment Design ,Middle Aged ,Radiography ,medicine.anatomical_structure ,Otorhinolaryngology ,Quality of Life ,Surgery ,Zygomatic arch ,Female ,business - Published
- 2014
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40. Surgical Management of Orbital Trapdoor Fracture in a Pediatric Population
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Giovanni Gerbino, Emanuele Zavattero, Francesca Antonella Bianchi, and Fabio Roccia
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Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Cicatrix ,Fracture Fixation, Internal ,Ocular Motility Disorders ,Fracture fixation ,Diplopia ,medicine ,Humans ,Surgical emergency ,Child ,Orbital Fracture ,Emergency Treatment ,Orbital Fractures ,Retrospective Studies ,Dysesthesia ,business.industry ,Retrospective cohort study ,eye diseases ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Otorhinolaryngology ,Oculomotor Muscles ,Female ,Eyelid ,Oral Surgery ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Follow-Up Studies ,Orbital Implants ,Pediatric population - Abstract
Purpose Orbital trapdoor fractures are pure orbital floor fractures with herniation and entrapment of the orbital contents, leading to restricted eye movement and diplopia. Trapdoor fractures in children have been discussed widely in published reports; however, the treatment policy and outcome remain controversial, although early treatment has been advocated. Our retrospective study analyzed the long-term results of pediatric patients undergoing surgery for trapdoor fractures to determine the outcome in relation to the type of fracture and the timing and technique of intervention. Patients and Methods The present study included 24 patients (age range 6 to 16 years) who underwent surgery for trapdoor fractures from 1998 to 2007. The demographic, etiologic, radiologic, and surgical findings, interval between trauma and surgery, surgical techniques, and complications were recorded. Diplopia, ocular motility, dysesthesia, and scar quality were recorded at follow-up. Results The follow-up duration averaged 36 months. At follow-up, 1 (8.3%) of 12 patients who underwent surgery within 24 hours (urgent treatment) had residual diplopia. In contrast, 3 (37.5%) of 8 patients who underwent surgery 24 to 96 hours (early treatment) and 4 (100%) of 4 who underwent surgery after 96 hours (late treatment) had diplopia. No sensory deficit of the skin or unesthetic eyelid scar was noted. Conclusions We found a correlation between the outcome and the timing of surgery for trapdoor fractures in the pediatric population. The success rate was significantly better when the fractures were treated within 24 hours of the injury. The results of the present study have strengthened the assertion that trapdoor orbital fractures pose a true surgical emergency.
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- 2010
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41. Use of Patient and Observer Scar Assessment Scale for Evaluation of Facial Scars Treated With Self-Drying Silicone Gel
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Francesca Antonella Bianchi, Paola Fiorini, Sid Berrone, and Fabio Roccia
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Scars ,Skin Pigmentation ,Severity of Illness Index ,Silicone Gels ,Cicatrix ,chemistry.chemical_compound ,Vascularity ,Silicone ,Suture (anatomy) ,Severity of illness ,medicine ,Humans ,Prospective Studies ,Aged ,Massage ,Pliability ,Wound Healing ,business.industry ,General Medicine ,Middle Aged ,Surgery ,Treatment Outcome ,Otorhinolaryngology ,chemistry ,Face ,Female ,medicine.symptom ,business - Abstract
In this prospective study, we used the Patient and Observer Scar Assessment Scale (POSAS) to evaluate the outcome of the healing process of posttraumatic and surgical facial scars that were treated with self-drying silicone gel, by both the patient and the observer. In our division, the application of base cream and massage represents the standard management of facial scars after suture removal. In the current study, 15 patients (7 men and 8 women) with facial scars were treated with self-drying silicone gel that was applied without massage, and 15 patients (8 men and 7 women) were treated with base cream and massage. Both groups underwent a clinical evaluation of facial scars by POSAS at the time of suture removal (T0) and after 2 months of treatment (T1). The patient rated scar pain, itch, color, stiffness, thickness, and surface (Patient Scale), and the observer rated scar vascularity, pigmentation, thickness, relief, pliability, and surface area (Observer Scale [OS]). The Patient Scale reported the greatest improvement in the items color, stiffness, and thickness. Itch was the only item that worsened in the group self-drying silicone gel. The OS primarily reported an improvement in the items vascularization, pigmentation, and pliability. The only item in the OS that underwent no change from T0 to T1 was surface area. The POSAS revealed satisfactory healing of posttraumatic and surgical facial scars that were treated with self-drying silicone gel.
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- 2010
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42. Bilateral Mandibular Angle Fractures
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Paolo Boffano and Fabio Roccia
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Adult ,Male ,Molar ,Time Factors ,medicine.medical_treatment ,Bone Screws ,Joint Dislocations ,Dentistry ,Poison control ,Violence ,Fracture Fixation, Internal ,Young Adult ,stomatognathic system ,Mandibular Fractures ,Occlusion ,Fracture fixation ,Bone plate ,Humans ,Surgical Wound Infection ,Medicine ,Device Removal ,Reduction (orthopedic surgery) ,Retrospective Studies ,business.industry ,Retrospective cohort study ,General Medicine ,Antibiotic Prophylaxis ,Jaw Fixation Techniques ,Treatment Outcome ,Otorhinolaryngology ,Tooth Extraction ,Female ,Molar, Third ,Surgery ,business ,Bone Plates ,Follow-Up Studies - Abstract
The mandibular angle is a frequent site of fracture. It is a weak zone that is more exposed to fractures than other areas of the mandibular bone. The presence of incompletely erupted third molars is associated with a further increased risk of angle fractures. Our objective was to evaluate and discuss the surgical outcomes of a group of patients with bilateral mandibular angle fractures.In our study, patients with bilateral mandibular angle fractures surgically treated from January 1, 2001, to June 30, 2009, at the Division of Maxillofacial Surgery of the University of Turin were retrospectively analyzed. A combined transbuccal and intraoral approach or an intraoral approach only was adopted.Eight patients (7 men and 1 woman) underwent surgery for bilateral mandibular angle fractures. Good to satisfactory reduction of the fractures was obtained with both surgical techniques. Good to fair restored occlusion was observed postoperatively in all patients.Successful treatment of bilateral mandibular angle fractures may be achieved via different techniques. Superficially impacted third molars seem to be associated with an increased risk of angle fractures. Bilateral angle fractures are an ideal model to study the biomechanical pathogenesis of angle fractures.
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- 2010
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43. Surgical Extraction of Deeply Horizontally Impacted Mandibular Second and Third Molars
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Fabio Roccia, Paolo Boffano, Cesare Gallesio, and Francesca Antonella Bianchi
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Molar ,Bone Regeneration ,Dentistry ,Mandible ,Mandibular first molar ,Mandibular second molar ,Young Adult ,stomatognathic system ,Radiography, Panoramic ,Surgical extraction ,Humans ,Medicine ,Tooth Socket ,Surgical treatment ,Mastication ,Orthodontics ,business.industry ,Impaction ,Tooth, Impacted ,General Medicine ,Osteotomy ,Treatment Outcome ,Increased risk ,Otorhinolaryngology ,Bone Substitutes ,Tooth Extraction ,Female ,Molar, Third ,Surgery ,business ,Follow-Up Studies - Abstract
The presence of deeply horizontally impacted lower second and third molars is unusual. The arrested eruption of the lower second and third molars can determine disturbances of mastication and aesthetics. Moreover, an increased risk of caries in the distal side of the first lower molar is possible. Different therapeutic approaches could be proposed for second and third molar impaction and malposition. In this article, we report the management and the outcome of the surgical treatment of a patient with impacted mandibular second and third molars.
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- 2010
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44. Surgical treatment and reconstruction for central giant cell granuloma of the jaws: A review of 18 cases
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Giulia Tanteri, Caterina Iaquinta, Massimo Fasolis, Paolo Tosco, Fabio Roccia, Sid Berrone, and Paolo Garzino-Demo
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Oral Surgical Procedures ,Alpha interferon ,Free flap ,Asymptomatic ,Surgical Flaps ,Lesion ,Young Adult ,Granuloma, Giant Cell ,Recurrence ,medicine ,Humans ,Mandibular Diseases ,Fibula ,Child ,Aged ,Aged, 80 and over ,business.industry ,Mandible ,Middle Aged ,Plastic Surgery Procedures ,medicine.disease ,Maxillary Diseases ,Osteotomy ,Surgery ,Radiography ,Treatment Outcome ,Otorhinolaryngology ,Maxilla ,Female ,Oral Surgery ,medicine.symptom ,business ,Central giant-cell granuloma ,Follow-Up Studies - Abstract
Summary Central giant cell granuloma (CGCG) is an uncommon benign bony lesion that occurs in the mandible and maxilla. The clinical behaviour of CGCG ranges from a slow-growing asymptomatic swelling to an aggressive lesion that presents pain, local bone destruction, root resorption and tooth displacement. Therapeutic options have varied greatly over the years. Non-surgical treatments with alpha interferon (α-IFN), calcitonin and corticosteroids have been described and their benefits may be worthy of consideration. Surgery is considered the traditional treatment and it is still the most accepted one, however in the literature not all authors agree on the type of surgery which should be performed. Although en bloc resection provides the lowest recurrence rate, only a few single case reports describe the use of this technique followed by reconstruction with autogenous bone grafts. The authors report their experience with en bloc resection of 18 wide CGCGs which had not been previously treated medically. Immediate reconstruction was carried out for all cases and in one, a fibula free flap was used to reconstruct the mandible. No recurrence was observed. After complete healing of the graft, prosthetic rehabilitation via implants was performed. This allowed the best functional and aesthetic results.
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- 2009
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45. Combined endovascular and surgical treatment of carotid body tumor in a patient with thoracic situs solitus
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Carlo Giordano, Giancarlo Pecorari, Juri Nadalin, Massimiliano Garzaro, and Fabio Roccia
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Adult ,Heart Defects, Congenital ,Thorax ,medicine.medical_specialty ,Hemodynamics ,Carotid Body Tumor ,medicine ,Humans ,Surgical treatment ,business.industry ,Radiologic examination ,Situs Inversus ,medicine.disease ,Embolization, Therapeutic ,Chronic hypoxia ,Surgery ,Radiography ,Situs inversus ,Treatment Outcome ,medicine.anatomical_structure ,Otorhinolaryngology ,Female ,Carotid body ,Radiology ,business ,Situs solitus - Abstract
Background Chemodectomas of the head and neck are tumors that originate from the neural crest. The authors report a case of carotid body tumor with chronic hypoxia secondary to congenital cyanogenic cardiac malformation, radiologically and surgically treated. Methods and Results A 37-year-old woman presented 1-year history of a slow-growing right lateral-cervical swelling. Radiologic examination led to a suspicion of carotid body tumor. Her history revealed thoracic situs solitus and a complex congenital heart disease. She was hospitalized for a selective angiography of the cervical vessels. Twenty-four hours later, the tumor was completely removed under local anesthesia. One year later, there were no signs of recurrence, and the patient showed a correct hemodynamic compensation. Conclusions The choice of surgical resection with selective preoperative embolization, which induced the obliteration of the feeder vessels, devascularizing the tumor and avoiding significant intraoperative bleeding, was successful. © 2008 Wiley Periodicals, Inc. Head Neck, 2008
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- 2008
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46. Management of Sport-Related Maxillofacial Injuries
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A. Nasi, Fabio Roccia, Sid Berrone, and Alberto Diaspro
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Maxillofacial injury ,Sex Factors ,Skiing ,Soccer ,medicine ,Animals ,Humans ,Horses ,Sports activity ,Child ,Aged ,Retrospective Studies ,Skull Fractures ,business.industry ,Horseback riding ,Incidence (epidemiology) ,Age Factors ,Follow up studies ,Treatment method ,Retrospective cohort study ,Recovery of Function ,General Medicine ,Length of Stay ,Middle Aged ,Surgery ,Hospitalization ,Affected site ,Italy ,Otorhinolaryngology ,Athletic Injuries ,Physical therapy ,Female ,Maxillofacial Injuries ,business ,human activities ,Follow-Up Studies - Abstract
By analyzing sports-related maxillofacial fractures, we sought to describe preventive measures and recovery times until sporting activities could be resumed. Between January 2001 and December 2006, 1241 patients were hospitalized as a result of maxillofacial fractures. The patients with sports-related maxillofacial fractures were analyzed based on age, sex, type of sport, injury mechanism, trauma site, presence of associated fractures, hospitalization, treatment method, and recovery time until the resumption of sporting activities. One hundred thirty-eight patients (11.4%) sustained sports-related maxillofacial fractures: 121 males and 17 females (ratio 8:1), aged between 11 and 72 years. The sport producing the greatest number of injuries was soccer (62.3%), followed by skiing (14.5%), and horseback riding (6.5%). The injuries involved mainly the middle third of the face (71.6%), and the mandible was the most affected site (27.2%), followed by the maxillary-zygomatic-orbital complex (25.9%). Treatment was surgery in 93.5% of the patients, with an average hospitalization period of 3.5 days. The protocol created to manage the follow-up of maxillofacial injury patients advised resuming sports activities at least 40 days after the trauma, except in the case of combat sports, when a period of 3 months was required. Although the results of this study indicate a reduction in the total incidence of sports-related maxillofacial injuries, they also show an alarming secondary increase in trauma resulting from the most popular sport in Italy-soccer. Therefore, stricter regulations are needed to discourage violent play, rather than relying on the use of protective equipment. Moreover, patients should be advised when they can resume sports activities, particularly in the case of professionals and semiprofessionals.
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- 2008
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47. European Maxillofacial Trauma (EURMAT) in children: A multicenter and prospective study
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Sigbjørn Løes, Vladislav A. Malanchuk, Emanuele Zavattero, Angel G. Bakardjiev, K. Hakki Karagozoglu, Peter Gordon, Vedran Uglešić, Paolo Boffano, Tymour Forouzanfar, Stephanie Akermann, Per Skjelbred, Andrey Kopchak, J. Longis, Brigitte Meijer, Milan Petrovic, Jonny Stephens, Žiga Kovačič, Pål Galteland, Pierre Corre, Nabeel Bhatti, Petia Pechalova, Amar Kanzaria, Vitomir S. Konstantinovic, Emil Dediol, Njål Lekven, Fanny Grimaud, Fabien Fauvel, Sofie C. Kommers, Aleš Vesnaver, Sean Laverick, Simon Holmes, Even Mjøen, Tiia Tamme, Fabio Roccia, Maxillofacial Surgery (VUmc), MKA VUmc (ORM, ACTA), Oral and Maxillofacial Surgery / Oral Pathology, and MOVE Research Institute
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Male ,Facial trauma ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Poison control ,Suicide prevention ,Condyle ,Occupational safety and health ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Risk Factors ,Injury prevention ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Dentistry (miscellaneous) ,Prospective Studies ,Child ,030223 otorhinolaryngology ,Prospective cohort study ,business.industry ,Infant, Newborn ,Infant ,030206 dentistry ,medicine.disease ,3. Good health ,Europe ,Child, Preschool ,Athletic Injuries ,Physical therapy ,Etiology ,Accidental Falls ,Female ,Maxillofacial Injuries ,Surgery ,Seasons ,Oral Surgery ,business - Abstract
ObjectiveThe aim of this study is to present and discuss the results of a European multicentre prospective study about pediatric maxillofacial trauma epidemiology during a year.Study DesignThe following data were recorded: gender, age, etiology, site of fracture, date of injury. Of the 3396 patients with maxillofacial fractures admitted within the study period, 114 (3.3%) were children aged 15 years and younger, with a male/female ratio of 2.6:1. Mean age was 10.9 years. Most patients (63%) were aged 11-15 years.ResultsThe most frequent cause of injury was fall (36 patients). Sport injuries and assaults were almost limited to the oldest group, whereas falls were more uniformly distributed in the 3 groups. The most frequently observed fracture involved the mandible with 47 fractures. In particular, 18 condylar fractures were recorded, followed by 12 body fractures.ConclusionsFalls can be acknowledged as the most important cause of facial trauma during the first years of life. The high incidence of sport accidents after 10 years may be a reason to increase the use of mouthguards and other protective equipment. Finally, the mandible (and in particular the condyle) was confirmed as the most frequent fracture site.
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- 2015
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48. Assault-related maxillofacial injuries: the results from the European Maxillofacial Trauma (EURMAT) multicenter and prospective collaboration
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Hélios Bertin, K. Hakki Karagozoglu, Milan Petrovic, Angel G. Bakardjiev, Paolo Boffano, F. Marion, Emanuele Zavattero, Per Skjelbred, Julien Guiol, Pål Galteland, Pierre Corre, Vedran Uglešić, Peter Gordon, Jonny Stephens, Stephanie Akermann, Žiga Kovačič, Emil Dediol, Amar Kanzaria, Fabio Roccia, Sigbjørn Løes, Petia Pechalova, Aleš Vesnaver, Tiia Tamme, Sofie C. Kommers, Even Mjøen, Simon Holmes, Tymour Forouzanfar, Andrey Kopchak, Vladislav A. Malanchuk, Njål Lekven, Nabeel Bhatti, Vitomir S. Konstantinovic, Sean Laverick, Oral and Maxillofacial Surgery / Oral Pathology, MOVE Research Institute, Maxillofacial Surgery (VUmc), and MKA VUmc (ORM, ACTA)
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Poison control ,Suicide prevention ,Occupational safety and health ,Pathology and Forensic Medicine ,03 medical and health sciences ,Fractures, Bone ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Injury prevention ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Dentistry (miscellaneous) ,Prospective Studies ,Cooperative Behavior ,Prospective cohort study ,Child ,Aged ,Demography ,Aged, 80 and over ,business.industry ,General surgery ,Human factors and ergonomics ,030206 dentistry ,social sciences ,Middle Aged ,Surgery ,Europe ,030220 oncology & carcinogenesis ,Child, Preschool ,Injury data ,Etiology ,Female ,Maxillofacial Injuries ,Oral Surgery ,business - Abstract
ObjectiveThe aim of this study is to present and discuss the demographic characteristics and patterns of assault-related maxillofacial fractures as reported by a European multicenter prospective study.Study DesignDemographic and injury data were recorded for each patient who was a victim of an assault.ResultsAssaults represented the most frequent etiology of maxillofacial trauma with an overall rate of 39% and the values ranging between 60.8% (Kiev, Ukraine) and 15.4% (Bergen, Norway). The most frequent mechanisms of assault-related maxillofacial fractures were fists in 730 cases, followed by kicks and fists. The most frequently observed fracture involved the mandible (814 fractures), followed by orbito-zygomatic-maxillary complex fractures and orbital fractures.ConclusionsOur data confirmed the strong possibility that patients with maxillofacial fractures may be victims of physical aggression. The crucial role of alcohol in assault-related fractures was also confirmed by our study.
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- 2015
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49. An audit of mandibular fractures treated by intermaxillary fixation using intraoral cortical bone screws
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Amedeo Tavolaccini, Fabio Roccia, Alessandro Dell'Acqua, and Massimo Fasolis
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Adult ,Male ,Adolescent ,Radiography ,Bone Screws ,Dentistry ,Fixation (surgical) ,stomatognathic system ,Fracture Fixation ,Mandibular Fractures ,Occlusion ,Fracture fixation ,Humans ,Medicine ,Tooth Root ,Oral mucosa ,Aged ,Retrospective Studies ,Orthodontics ,Medical Audit ,business.industry ,Middle Aged ,medicine.disease ,stomatognathic diseases ,medicine.anatomical_structure ,Otorhinolaryngology ,Female ,Surgery ,Cortical bone ,Oral Surgery ,Malocclusion ,business ,Complication - Abstract
Summary Introduction During the last 10 years, intermaxillary fixation using intraoral cortical bone screws has been introduced for the treatment of mandibular fractures. The aim of this work was to evaluate the indications and possible complications of this method. Materials and methods Sixty-two patients with mandibular fractures, treated by intermaxillary fixation using these screws, were evaluated by preoperative and postoperative panoramic radiographs. Clinical testing was carried out for vitality and abnormal mobility of teeth adjacent to the site of screw insertions. To evaluate the efficacy of this method, different factors were considered such as possible iatrogenic dental injuries, loss, breakage or screw cover by oral mucosa and postoperative occlusion. Results The most important complication was iatrogenic damage to dental roots (1.5%), 4.9% of the screws were covered by oral mucosa and 1.9% were lost, while none were broken. Malocclusion was observed in one patient (1.6%) and lack of consolidation of a displaced fracture of the mandibular body in another patient. Conclusions Use of intraoral cortical bone screws for intermaxillary fixation is a valid alternative to arch bars in the treatment of mandibular fractures. Iatrogenic injury to dental roots is the most important problem of this procedure, but can be minimized by an experienced surgeon.
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- 2005
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50. Review of Peripheral Giant Cell Granulomas
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Massimiliano Garzaro, Cesare Gallesio, Giancarlo Pecorari, Paolo Boffano, Rodolfo Benech, and Fabio Roccia
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Adolescent ,MEDLINE ,Young Adult ,Granuloma, Giant Cell ,medicine ,Humans ,Sex Distribution ,Young adult ,Child ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Jaw Neoplasms ,Peripheral ,Italy ,Otorhinolaryngology ,Giant cell ,Granuloma ,Female ,Surgery ,business - Published
- 2013
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