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Background: Maxillofacial injuries, due to their diverse etiological causes, are often considered a component of multi-trauma and constitute a significant portion of trauma. This study aims to elucidate the incidence of maxillofacial traumas, particularly among military personnel, various clinical courses, and characteristics, thereby contributing to the literature., Methods: Forensic reports, primarily related to military personnel and organized between 2011 and 2016 at the Forensic Medicine Department of Gülhane Medical Faculty, Health Sciences University, were retrospectively examined. The study involved a detailed analysis of cases with maxillofacial injuries resulting from trauma, focusing on aspects such as age, gender, the origin of the trauma, degree of injury, the presence of bone and dental fractures, and the occurrence of psychiatric disorders as a result of the trauma., Results: This study demonstrated that maxillofacial traumas predominantly occurred in young male individuals, particularly among military personnel. The most common etiological factor identified was interpersonal violence. The majority of injuries were soft tissue damages, with the nasal bone being the most frequently fractured area. Injuries to the head and upper extremities were also detected in some of the cases, showing that multiple injuries are common in such cases. Post-traumatic psychological disorders developed in some cases, with anxiety disorders being the most commonly observed., Conclusion: It has been determined that maxillofacial injuries can affect multiple body regions, necessitating a multidisciplinary approach. This study underscores the importance of developing comprehensive strategies and policies for understanding and managing maxillofacial traumas, providing a fundamental reference for future studies in this field.

Purpose: Trauma accounts for the leading cause of morbidity and mortality worldwide in the present day and may rightly be called the new pandemic. The prominent nature of the face exposes it to various traumatic injuries. A timely, prompt diagnosis along with employment of correct and quick treatment greatly improves the outcome for these patients. The aim of this retrospective study was to analyse the characteristics of maxillofacial injuries over a decade., Methods: The data were collected manually from the medical records of patients who reported to the tertiary centre from 1 January 2011 to 31 December 2019. All injured patients irrespective of age/gender with complete hospital records of clinical and radiographical diagnosis of maxillofacial injuries were included. The demographic data, etiology, site and type of injury, and seasonal variation were analyzed. Data were tabulated into 6 age groups (0 - 7 years, 8 - 18 years, 19 - 35 years, 36 - 40 years, 41 - 59 years, and > 60 years). Five etiological factors, i.e. road traffic accidents, falls, assaults, sports-related, and occupational accidents, were further evaluated based on genders. Facial injuries were classified into 6 types: panfacial fractures, mandibular fractures (subcategorized), midface fractures (subcategorized), dentoalveolar fractures, dental injuries, and soft tissue injuries. The monthly and seasonal variation of the injuries was also charted. Data were expressed as frequency and percent., Results: A total of 10,703 maxillofacial injuries were included from the tertiary centre from the period of 2011 - 2019, including 8637 males and 2066 females, with the highest occurrence in the 19 - 35 years age group. Road traffic accident was the principal etiological factor of maxillofacial injuries in both genders (80.5%), followed by falls (9.6%), assaults (8.0%), occupational accidents (1.2%), and sporting injuries (0.7%). Midface fractures accounted for 52.5% (5623 fractures), followed by mandibular fractures (38.1%)., Conclusion: The current study describes a change in the incidence of maxillofacial injuries along with variation in the demographic data. The implementation of safety gears and stricter traffic laws along with public awareness may aid in the reduction of maxillofacial injuries., (Copyright © 2022 Chinese Medical Association. Production and hosting by Elsevier B.V. All rights reserved.)

Purpose: The COVID-19 pandemic has affected the personal and social lives of millions of people and also impacted the etiological factors of midfacial trauma such as falls, interpersonal violence or traffic accidents. The aim of this study was to analyze the influence of the COVID-19 pandemic on maxillofacial trauma surgery in the German healthcare system., Methods: Nationwide data regarding the national diagnosis-related-group (DRG) inpatient billing system used in all German hospitals was received from the German Federal Statistical Office. Various trauma-associated procedures of the Operation and Procedure Classification System (OPS), a German modification of the International Classification of Medical Procedures (ICPM), were statistically associated with different epidemiological factors between 2012 and 2021., Results: A statistically significant decrease (p < 0.05) in surgeries regarding maxillofacial fractures was registered during the years 2020 and 2021. Young male patients had the largest decline in maxillofacial trauma surgeries during this period (p < 0.05). In contrast. elderly patients 80 years and older showed a dramatic increase in the frequency of fractures in both the midface and the mandible (p < 0.05)., Conclusions: During the COVID 19 pandemic there has been a shift in the number, composition and etiology of maxillofacial fracture surgeries. Measures of social distancing and personal risk avoidance had a societal positive effect on the frequency of facial injuries. This stands in contrast to the drastic increase in fractures of elderly people who should be protected primarily by the measures taken. These results can help to understand these influences better in future pandemics., Trial Registration: German Clinical Trials Register No: DRKS00032778., (© 2024. The Author(s).)

The safety of children's living environment is affected by several factors. Safer living environments have been offered as one explanation to decreases in children's fractures. Earlier studies provide evidence of a decreasing trend in children's fractures in the past decades. The objective of this study was to investigate demographic and clinical features of paediatric maxillofacial fractures during three time periods. A retrospective cross-sectional single-centre study was designed. The study included 474 patients aged ≤ 15 years admitted to Helsinki University Hospital in Finland with maxillofacial fractures during 1980-1989, 1993-2002 and 2013-2018. Maxillofacial fractures increased by 25% during the study period. The increase was greater in boys (28%) than in girls (19%), and significant in age groups 0-5 years (71%) and 13-15 years (32%). Exclusively mandibular fractures decreased by 20%, while exclusively midfacial fractures increased more than four-fold and exclusively upper-third fractures five-fold. Being hit by object and falls from height increased more than two-fold. A temporary increase in assaults and decrease in bicycle accidents in the middle period of the study was observed. During the three decades, paediatric maxillofacial fractures have increased and both fracture type and underlying aetiology have changed. These findings reflect improvements in diagnostics, traffic safety, regulations and technology. The role of factors such as interpersonal violence and economic fluctuation on the incidence of childhood maxillofacial fractures is discussed., (© 2024. The Author(s).)

In addition to the clinical burden of trauma, the financial burden is an important aspect of care globally, especially for patients in low- and middle-income countries. The current retrospective review was done of data from January 2015 to December 2020 related to patients of oral maxillofacial trauma management in a tertiary care setting. Analysis of variance was used to determine the mean difference in the cost incurred depending upon the type of trauma and the number of bone plates used in fracture management. Pearson correlation was applied to explore any correlation involving patient age, aetiology and type of fracture, number of bone plates employed and the length of stay in the hospital. No statistically significant differences were noted in the cost among the different groups. The cost of care was significantly (p<0.001) correlated to the length of stay. Other variables, such as the type of fractures and the number of plates, had no significant impact (p>0.05).

Background: The prevalence of maxillofacial and head injuries associated with electric scooters (e-scooter, ES) has risen in concordance with its popularity., Purpose: The purpose of this study was to compare maxillofacial and head injury location, type, and severity related to ES and bicycle accidents and to identify factors contributing to injury severity., Study Design, Setting, Sample: The authors implemented a multicenter retrospective cohort study in Seattle, Washington, and enrolled a sample of ES riders and bicyclists who sustained maxillofacial injuries between September 2020 and September 2022. The exclusion criteria included nonmotorized scooters, motorized bicycles, injuries with other operators, or vehicles, and pre-evaluation deaths., Predictor Variable: The predictor variable was vehicle type, bicycle or ES., Outcome Variables: The outcome variables included maxillofacial injury location, distinguished by horizontal facial thirds and injury type, defined as hard or soft tissue. Associated head injury types were also reported as hard (calvaria) or soft (scalp) tissue injuries. The severity of these injuries was quantified using both the injury severity score and the face and head abbreviated injury scale., Covariates: Demographic, injury, and treatment-related variables were collected., Analyses: Bivariate, multivariate, and regression statistics were computed. Statistical significance was P < .05., Results: The final sample was composed of 205 total subjects, of which 52 (25.4%) were in the ES group and 153 (74.6%) in the bicycle group. Isolated midface injuries were the most common hard tissue location in the ES (15.4%) and bicycle (29.4%) groups. The most common soft tissue injury location included the upper face and midface in the ES group (19.2%) and the midface in the bicycle group (22.9%). Both hard and soft tissue head injuries were more prevalent in the ES group (P < .0002 and P < .0001). Moreover, intracranial injuries were seen in 36.5% of ES subjects compared to 9.8% bicycle subjects (P < .0001). Between the two groups there was no difference in maxillofacial injury severity, but head injuries were more severe in the ES group (P < .0002). Using regression analysis, drug use was found to have a significant impact on the mean injury severity score (P < .002) and helmet use did not have significant impact on face or head injury severity., Conclusion: Maxillofacial injury location, type, and severity are comparable among ES and bicycles. However, ES riders are at greater risk of severe head injuries compared to bicycles, and riding while intoxicated has the greatest effect on injury severity., (Copyright © 2024 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background/aim: Results of studies investigating the association between traumatic brain injury (TBI) and maxillofacial fractures (MFs) have varied considerably. The present study aimed to evaluate the correlation between TBIs and MFs, as well as the impact of age, sex, trauma mechanism, and season on TBIs., Materials and Methods: This 12-year retrospective study of 2841 patients used univariate and multivariate logistic regression to assess the association between MFs and other factors impacting TBIs., Results: Among 2841 patients, 1978 TBIs occurred in 829 (29.2%), with intracranial injuries (n = 828) is the most common. Of 829 patients with TBIs, 688 were male and 141 were female, corresponding to a male-to-female ratio of 4.9:1.0. The most common age group was 40-49 years (24.6%). Vehicles (including motor vehicles and electric vehicles) accidents were the primary causes of injuries. Multivariate regression analyses revealed an increased risk for TBIs among males (odds ratio [OR] 0.632, p < 0.001). Patients >40 years of age were at higher risk for TBIs, especially those ≥70 years (OR 3.966, p = 0.001). Vehicle accidents were a high-risk factor for TBIs (OR 6.894, p < 0.001), and winter was the most prevalent season for such injuries (OR 1.559, p = 0.002). Risk for TBI increased by 136.4% in combined midfacial and mandibular fractures (p = 0.016) and by 101.6% in multiple midfacial fractures (p = 0.045). TBIs were less common in single mandibular fractures, notably in single-angle fractures, with a risk of only 0.204-fold., Conclusion: TBIs in MFs were significantly correlated with sex, age, aetiology, season and fracture location. Maxillofacial surgeons and emergency physicians must be aware of the possible association between TBIs and MFs to assess and manage this complicated relationship in a timely manner., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

Background: This study investigates maxillofacial fractures in non-indigenous ethnic groups who were reviewed in the national maxillofacial unit in Ireland. The aim of this study was to highlight any potential trends in presentation of facial fractures in non-indigenous groups in comparison to previous reports which have included all ethnicities. This unique study is based on the fact that Ireland has only recently transformed into a diverse, multi-cultural country. This is unlike countries such as the UK and USA which have a long history of multicultural integration., Materials and Methods: This retrospective study evaluated the trauma database of 4761 patients with 5038 fractures who attended the national maxillofacial unit over a 5-year period from 2015 to 2019. Parameters included age, gender, mechanism of injury, fracture sustained, time of the day, day of the week, month of injury, and the referral source were obtained from patient records., Results: The study identified 456 patients who did not identify as being born in Ireland, with 384 males and 72 females. The most common fracture seen was of the zygomatic bone, and the most common mechanism of injury was alleged assault for this cohort. Most injuries occurred in late afternoon with Friday being the most common day of the week., Conclusion: This study shows how maxillofacial units need to adapt to the changing trends in Irish demographics with increased demand for resources such as translation services. A further study could evaluate the rapidly changing demographic with mass migration of people currently seeking refuge in Western Europe., (© 2024. The Author(s).)

Similar to other developing countries, the elderly population has increased in Türkiye in the last 30 years. Due to this increase, there has been a rise in the number of elderly patients suffering from maxillofacial injuries. This retrospective study aimed to evaluate the data of patients with geriatric facial trauma treated in our trauma center between 2010 and 2022 and the leading types of injuries, their causes, accompanying findings, and preferred treatment methods according to sex and age. In the study, the demographic characteristics, including age, sex, comorbidities, causes and sites of injury, treatment options, accompanying injuries, and facial injury severity scores of 292 patients were analyzed. Among more than 4000 patients undergoing treatment for maxillofacial injuries screened from January 2010 to August 2022, 292 (166 males, 56%; age range, 65-98 years) fulfilled the eligibility criteria for the study, of whom 60 had a surgical operation. Falls were the most typical cause of injury (70.20%), followed by motor vehicle accidents (18.15%) and assaults (7.87%). Zygomaticomaxillary complex fractures were the most frequently encountered fracture type (n=126, 29.92%), followed by nose fractures (n=122), orbital fractures (n=85), and mandible fractures (n=72). It was observed that the fractures were managed by surgical intervention or conservative measures and that conservative treatment was mostly preferred at an increasing rate with advancing age. As the elderly population increases, so does the incidence of geriatric facial trauma. Due to increased age, deterioration of health, and increase in the number of comorbidities, surgical interventions are less preferred., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: The percentage of elderly trauma patients under anticoagulation and antiplatelet agents has been rising lately. As newer agents are introduced, each comes with its own advantages and precautions. Our study covered elderly patients admitted to the ED with maxillofacial trauma while on anticoagulation (AC) or antiplatelet therapy (APT). We aimed to investigate the demographic characteristics, causes, and types of maxillofacial trauma, along with concomitant injuries, duration of hospitalisation, haemorrhagic complications, and the overall costs of care in the emergency department (ED)., Methods: Data were gathered from the ED of Bern University Hospital. In this retrospective analysis, patients over 65 of age were included, who presented at our ED with maxillofacial trauma between 2013 and 2019 while undergoing treatment with therapeutic AC/APT., Results: The study involved 188 patients with a median age of 81 years (IQR: 81 [74; 87]), of whom 55.3% (n=104) were male. More than half (54.8%, n=103) were aged 80 years or older. Cardiovascular diseases were present in 69.7% (n=131) of the patients, with the most common indications for AC/APT use being previous thromboembolic events (41.5%, n=78) and atrial fibrillation (25.5%, n=48). The predominant cause of facial injury was falls, accounting for 83.5% (n=157) of cases, followed by bicycle accidents (6.9%, n=13) and road-traffic accidents (5.3%, n=10). The most common primary injuries were fractures of the orbital floor and/or medial/lateral wall (60.1%, n=113), zygomatic bone (30.3%, n=57), followed by isolated orbital floor fractures (23.4%, n=44) and nasal bone fractures (19.1%, n=36). Fractures of the mandible occurred in 14.9% (n=28). Facial hematomas occurred in 68.6% of patients (129 cases), primarily in the midface area. Relevant facial bleeding complications were intracerebral haemorrhage being the most frequent (28.2%, n=53), followed by epistaxis (12.2%, n=23) and retrobulbar/intraorbital hematoma (9%, n=17). Sixteen patients (8.5%) experienced heavy bleeding that required emergency treatment. The in-hospital mortality rate was 2.1% (4 cases)., Conclusions: This study indicates that falls are the leading cause of maxillofacial trauma in the elderly, with the most common diagnoses being orbital, zygomatic, and nasal fractures. Haemorrhagic complications primarily involve facial hematomas, especially in the middle third of the face, with intracerebral haemorrhage being the second most frequent. Surgical intervention for bleeding was required in 8.5% of cases. Given the aging population, it is essential to improve prevention strategies and update safety protocols, particularly for patients on anticoagulant/antiplatelet therapy (AC/APT). This can ensure rapid diagnostic imaging and prompt treatment in emergencies., (© 2024. The Author(s).)

In India, 21.20% of annual road traffic accidents (RTA) result in maxillofacial injuries, with most victims being young adults aged 18-45 years. Such RTAs cause personal losses to individuals and families and adversely impact the country's health system facilities. These losses result from the expenses for medical care, lost wages for individuals who are rendered unable to work, and lost productivity for family members who must miss work or school in order to care for the injured. Most nations lose 3% of their gross domestic product to road accidents. RTA injuries, often associated with severe morbidity, cause functional impairments and have immense psychological impact. Rehabilitating these patients and their future treatment needs constitute an economic burden to themselves and their families, more so in a developing country like India, where a majority of the population cannot afford the treatment costs and lack health insurance coverage. These injuries therefore, as defined by the International Classification of Functioning, Disability and Health 2001, fall within the ambit of impairment and disability. However, Indian law does not identify maxillofacial injuries and the ensuing trauma as disabilities. Addressing this could be an important step towards improvement in the care and compensation provided to survivors of such life changing accidents.

Background: Patients sustaining maxillofacial fractures are at risk for associated injuries (AIs) to other body regions. The incidence of AIs is reported to be from 20 to 35%. AIs may be life-threatening and play a key role in considering first-line management at the emergency department, as well as planning the definitive treatment of maxillofacial fractures., Purpose: The study aimed to determine the frequency and risk factors for AIs in patients with maxillofacial fractures., Study Design, Setting, Sample: The investigators designed and implemented a retrospective cohort study of patients with facial fractures treated at Central Hospital (Lahti, Finland) from January 1, 2009 through December 31, 2019. All adult patients with verified maxillofacial fractures were included. Patients under 18 years of age were excluded from the study., Predictor Variable: The predictor variable was the location of the maxillofacial fractures grouped into three categories: mandible alone, midface alone, and both midface and mandible., Main Outcome Variable(s): The primary outcome variable was associated body region injuries coded as present or absent. The secondary outcome variable was the location of the AI categorized as skull, neck, thorax, pelvis, or extremity injuries., Covariates: Other study variables included demographic data (age, sex, alcohol use), Glasgow Coma Scale, and etiology (fall, traffic- and bicycle accident, assault, pedestrian hit by motor vehicle, work-related, or sports/free-time injuries)., Analyses: Continuous variables were analyzed for normal distribution using the Shapiro-Wilks test and compared with categorical variables using the Mann-Whitney test. The univariate analyses of categorical variables were analyzed by the χ 2 test (P ≤ .05 was considered statistically significant)., Results: During the study period, 443 adult (≥18) patients had maxillofacial fractures. AIs were present in 88 subjects (20%). The mean age was 47.6 years (range 18-91); 52 years with AIs (range 19-91), and 47 years (range 18-92) without AIs (P = .03). Subjects with midface and mandible + midface fractures had greater risk to AIs compared to mandibular fractures (relative risk 2.0, P = .002, relative risk 2.8, P = .009)., Conclusion and Relevance: Every fifth maxillofacial trauma patient had an associated injury. Trauma patients should be evaluated in institutions with trauma protocols and imaging modalities before determining and executing the treatment plan for maxillofacial fractures., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Oral and maxillofacial trauma is influenced by various factors, including regional characteristics and social background. Due to the coronavirus disease 2019 (COVID-19) pandemic, a state of emergency was declared in Japan in March 2020. In this study, we aimed to examine the dynamics of patients with oral and maxillofacial trauma over a 12-years period using interrupted time-series (ITS) analysis. Patients were examined at the Shimane University Hospital, Maxillofacial Trauma Center from April 2012 to April 2023. In addition to general patient characteristics, data regarding the type of trauma and its treatment were obtained from 1203 patients (770 men and 433 women). Group comparisons showed significant differences in age, trauma status, method of treatment, referral source, route, and injury occasion. ITS analysis indicated significant changes in combined nasal fractures, non-invasive reduction, and sports injuries (P < 0.05), suggesting COVID-19 significantly impacted oral and maxillofacial trauma dynamics. A pandemic of an infectious disease may decrease the number of minor trauma cases but increase the number of injuries from outdoor activities, resulting in no overall change in the dynamics of the number of trauma patients. Medical systems for oral and maxillofacial trauma should be in place at all times, independent of infectious disease pandemics., (© 2024. The Author(s).)

Background: Though the epidemiology of craniomaxillofacial (CMF) fractures has been well documented at urban hospitals, the characteristics of these fractures in rural hospitals have not been well studied., Purpose: The purpose of this study is to report on the epidemiology of CMF fractures at a regional Level 1 trauma center serving a large rural population in central Illinois., Study Design, Setting, Sample: This is a retrospective cohort study at a community-based regional tertiary referral center that serves a predominantly rural population. Inclusion criteria comprised patients with radiologically confirmed CMF fractures between 2015 and 2019. Patients with incomplete medical records were excluded., Predictor Variable: Predictor variables included demographics (age, admission source, race, and sex) and etiology of CMF fracture (assault/domestic violence, all-terrain vehicle/off-road, falls, farm-related, motor vehicle collisions, gunshot wound, and others)., Main Outcome Variable: The primary outcome variable was the CMF anatomic location including nasal bone, orbit, mandible, malar/maxillary, and other CMF fractures., Covariates: The covariates are not applicable., Analyses: Descriptive statistics were used to summarize a sample of the population characteristics. Wilcoxon ranked sign tests and χ 2 tests of independence were used to assess for statistically significant associations between select variables of interest. Statistical significance was defined as P < .05., Results: Between 2015 and 2019, a total of 2,334 patients presented to the emergency department with a CMF fracture. After applying the inclusion/exclusion criteria, the final sample was composed of 1,844 patients for the management of 2,405 CMF fractures. The majority of patients were male(62.0%) and young adults (aged 18-39) had the highest number of CMF fractures (819) relative to all other age groups. The most common fracture etiology was fall(37.3%), and nasal bone fractures represented the most common fracture location(41.6%). χ 2 analyses revealed statistically significant associations between the anatomic location of CMF fracture incurred, and differing categories of age, admission source, race, sex, and etiology., Conclusion and Relevance: Our study shows that patients seen at our Midwestern Level 1 trauma center are more likely to present with nasal bone and malar/maxillary fractures due to falls. In studies based in urban centers, patients are likely to present with orbital and mandibular fractures due to falls and assault., (Copyright © 2024 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: The oral and maxillofacial complex is subject to a range of traumas. Injuries to the region are devastating and have a great impact on social health outcomes. This review intends to investigate the aetiologies of maxillofacial trauma across Australia., Methods: This review was written in accordance with the PRISMA-ScR. Comprehensive searches of CINAHL, MEDLINE, Ovid, Scopus, and Web of Science databases were conducted to identify potentially relevant literature. Quantitative observational epidemiological studies were sought and were required to include at least one aetiology to the maxillofacial region in their data set. A total of 31 eligible studies were included., Results: The greatest recorded causes of maxillofacial injuries included inter-personal violence (34.98%) falls (20.87%), sports (15.62%), and motor-vehicle accidents (14.31%). These four aetiologies cumulatively accounted for more than 85% of maxillofacial injuries. From all sustained injuries (n = 7661), the orbit was the most prevalent site of fracture (31.85%), followed by the zygoma (22.01%), mandible (21%), nasal bone (12.45%), maxilla (10.04%), dentoalveolus (1.84%), antrum (<1%), and frontal bone (<1%)., Conclusion: Violence was an unprecedented cause of trauma-additional research is recommended to further characterize the correlation between the two variables. Research is also recommended specifically in regional/rural communities, where data was particularly limited. © 2024 Australian Dental Association., (© 2024 The Authors. Australian Dental Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Dental Association.)

Aging may increase the risk of maxillofacial and dentoalveolar trauma (MDT). This review assessed global trends in scientific publications on MDT in the elderly. Six databases were searched. Studies about MDT in the elderly (≥60 years old) were included in two text mining stages (S1 and S2). In S1, all studies with elderly subjects were included, while in S2 only studies in which the elderly were assessed in a separate set of data or in a subanalysis by age groups were included. In S1, relevant data were mined using VantagePoint™ software. In S2, data were descriptively analyzed. There were 2265 studies at S1 and 110 at S2. The publication dates spanned from 1963 to 2023. In S1, the most cited keywords and terms were aged (n = 1872), male (n = 1839), female (n = 1777), "mandible fracture" (n = 460), "orbit fracture" (n = 362), and "maxilla fracture" (n = 118). Thirty authors published 10 or more articles with visible collaboration networks. There was a progressive increase in publications, especially in Europe (n = 150). In S2, most studies were case reports/case series (n = 62). The primary etiology was accidental falls (n = 84), the most affected region was the middle third of the face (n = 65), and dental trauma was rarely reported (n = 15). Cone Beam computed tomography was the most used diagnostic tool (n = 67). Of the 81 articles that addressed therapy, 52 opted for surgical treatment. Although there has been an increase in the number of articles on MDT over the years, studies with the elderly population as a specific study group are still needed. Accidental falls were the most reported etiology, while the middle third of the face and the mandible were the anatomic region and bone most affected, respectively. The high number of case reports indicates the need for improvement in the available scientific evidence about MDT in the elderly., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: This study aims to analyze the clinical epidemiology, diagnostic and treatment characteristics of minor patients with maxillofacial fracture and provide a reference for the prevention and treatment., Methods: The clinical data of minor patients with maxillofacial fracture in Departmentof Traumatic and Plastic Surgery, West China Hospital of Stomatology, Sichuan University, from January 1, 2015 to December 31, 2020 were retrospectively studied and statistically analyzed in terms of age, gender, etiology, anatomic sites and treatment modalities., Results: The mean age of the patients was (10.65±5.15) years, and the male-to-female ratio was 1.91∶1. High fall was the primary cause of maxillofacial fractures in minors aged 0-6 years. Traffic accident injuries were the main cause of maxillofacial fractures in minors aged 7-12 and 13-17 years. About 65.13% of the midface and 83.08% non-condylar fractures were mainly treated by surgery, and condylar fractures were treated conservatively in 74.73% and by surgical treatment in 25.27%., Conclusions: The etiology of maxillofacial fractures in minors differs at different ages, so prevention strategies should be adjusted according to age. Surgical treatment has become the preferred treatment modality for midface and non-condylar fractures. Conservative treatment is still the main treatment method for condylar fractures, but the proportion of surgical treatment increases.

Background: In December 2019, an outbreak of a novel pneumonia-like illness, COVID-19 (C-19), emerged in Wuhan, China. In March 2020, as the incidence of C-19 rose, the Israeli government, like that of other nations, declared a national state of emergency, and a full, general lockdown was announced., Purpose: The purpose of this study is to determine the incidence and characteristics of pediatric maxillofacial trauma presentation during the 2020 C-19 lockdown restrictions and compare them to periods outside lockdown between 2019 and 2020 (pre-C-19)., Study Design, Setting, Sample: A retrospective cohort study was conducted and included all pediatric patients (0-18 years) referred to the emergency department (ED) at Tzafon Medical Center, Israel, and diagnosed with maxillofacial injuries. Patients with missing demographic data and patients who did not complete the medical examination were excluded., Predictor/exposure/independent Variable: The exposure variable is the date of injury-2020 C-19 lockdown period compared to the previous year (pre-C-19)., Main Outcome Variable(s): The main outcome variable was the number of pediatric maxillofacial trauma ED arrivals out of total pediatric ED arrivals and out of total maxillofacial ED arrivals., Covariates: Covariates included patient demographics, etiology, and place of injury., Analyses: The association between categorical variables was tested using the Fisher exact test or χ 2 test for binary variables with relative risk when appropriate, logistic regression model used to predict outcome variable. P values were 2-tailed and statistical significance was defined as P < .05., Results: The study sample comprised 1174 patients. Relative risk of presenting with oral and maxillofacial trauma out of all pediatric ED patients was 1.85 comparing C-19 period to pre-C-19 period (confidence interval [1.65; 2.073], P < .0001). Most of the injuries recorded during the C-19 restrictions occurred in the domestic environment (56.1% compared to 47.5% in pre-C-19, P < .001). Incidences necessitating treatment increased from 45.8 to 55% during C-19 (P = .002)., Conclusion and Relevance: During C-19, there was a higher rate of pediatric injuries compared to pre-C-19. The incidence of domestic oral and maxillofacial injuries increased despite the considered home safety., (Copyright © 2024 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to evaluate the incidence and patterns of maxillofacial fractures and the demographic characteristics of associated head and neck injuries. This single-center retrospective cohort study was conducted at the Department of Oral and Maxillofacial Surgery of King Abdullah University Hospital (KAUH) in Irbid, northern Jordan. The data was obtained from the electronic clinical records of all patients in whom maxillofacial fractures and associated head and neck injuries were confirmed. During the five-year period captured by this retrospective study, 481 patients with 1026 maxillofacial fractures (equivalent to 2.13 fractures per patient) were treated. The sample comprised of 369 (76.7%) males and 112 (23.3%) females, resulting in a male/female ratio of 3.3:1. Majority of the patients were in the 21-30 age group and RTA was the most common cause of maxillofacial fractures, accounting for 299 (62.1%) of the analyzed cases. In 316 cases, maxillary fractures were accompanied by associated injuries, 132 (41.77%) of which were intracranial lesions, 80 (25.32%) were skull fractures, and 59 (18.67%) were cervical spine injuries. Based on the obtained data, it can be concluded that the high occurrence of RTA emphasizes the significance of adhering to traffic laws and regulations, as individuals who have suffered serious head and neck injuries as a result of maxillofacial trauma may experience potentially fatal consequences. Thus, management for patients with maxillofacial fractures and concomitant traumas should be multidisciplinary and coordinated., Competing Interests: Declaration of competing interest The author declares that no conflict of interest. This study was not funded., (Copyright © 2024 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Objectives: To report and analyze the pattern of maxillofacial injuries in trauma victims and to define the role of a maxillofacial surgeon in an emergency trauma care team., Materials and Methods: Trauma patients reported and reporting to the casualty of a tertiaryhospital with facial injuries and other suspected concomitant injuries in the body were included in this study. The complete medical and radiographic records of each patient were reviewed and data was collected in a standard proforma in this 5-year clinical study (3 year of retrospective and 2 year of prospective study). The complete data related to the facial injuries and associated systemic trauma was recorded and statistical analysis conducted., Results: A total of 18,369 patients with trauma were admitted to the hospital from May 2018 to April 2023. Out of these, 11,277 (61.4%) were males and 7,092 (38.6%) were females. Seventy percent of the reported cases with trauma were in the age group of 14-40 years. The incidence of trauma during the monsoon season was highest (n = 7,927, 43%). The commonest etiological factor leading to trauma was road traffic accident (n = 4,510, 40%). Among facial injuries, the mandibular fractures (n = 1,821, 41%) were predominant., Conclusions: The management of polytrauma patients should be undertaken by a team of specialists which should include a maxillofacial surgeon as facial injuries were common. This data is essential in developing and assessing the preventative strategies aimed at decreasing the frequency of facial and other injuries.

Background: This retrospective study analysed the epidemiology of maxillofacial trauma over 22 years to assess whether there have been significant changes in the causes and characteristics of fractures in paediatric, adult and elderly populations., Materials and Methods: The following data were collected: age, sex, injury cause and mechanism, fracture site, Facial Injury Severity Scale, associated injuries, time of injury, type of treatment and length of hospital stay. The patients were analysed by age group (children [≤16 years], adults [17-60 years] and elderly [>60 years]) and divided into two time groups (group 1: 2001-2011; group 2: 2012-2022) that were compared to each other. Statistical analyses were performed using SPSS software., Results: Between 01 January 2001 and 31 December 2022, 3535 patients (2690 males and 845 females, mean age 39.3 years) were admitted for facial fractures. The comparison of the two temporal periods showed a decrease in the prevalence of males (p = .02), in road traffic injuries (p < .001), and in fractures of the lower third of the face (p = .005); there were significant increases in the mean age (p < .001), prevalence of the elderly (p = .006) and in fall- and assault-related injuries (p < .001 and p = .03, respectively). Assault injuries increased only in the 17-60 age group (p = .02) while RTA-related fractures decreased in all age groups (p < .05 for all comparisons). Bicycle accidents increased significantly, with a parallel decrease in motor vehicle accidents (both p < .001). Fall-related fractures increased only in 17-60 and >60 age groups (p < .001 and p = .02, respectively)., Conclusions: This study shows significant changing trends in the epidemiology of maxillofacial trauma. While road traffic policies have been effective in the last years, preventive measures for falls in the elderly population and new legislative measures to prevent interpersonal violence should be advocated., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: This study aimed to assess the incidence and pattern of maxillofacial fractures and related demographic data in the victims of rollover crashes., Patients and Methods: This retrospective study was based on medical records of patients who sustained maxillofacial injuries following rollover accidents. Investigated data included age, gender, accident date and time, accident cause, seat belt usage, airbag deployment, road type, anatomical location of the facial fracture, and treatment approach., Results: Among the 147 patients who met the inclusion criteria, the most prevalent age groups were 20-30 (36.7%) and 30-40 (32.7%) years, with a mean age of 33.6 ± 9.7 years. The male-to-female ratio was 6:1. Most crashes occurred in March, August, and July. These accidents involved 69.4% light vehicles and 39.6% heavy vehicles. The leading causes of rollover crashes were speeding (58.5%) followed by distracted driving (21.1%) and traffic rule violations (13.6%). The most prevalent injuries were fractures of the maxillary sinus wall (40.8%), nasal bones (39.5%), zygomaticomaxillary complex (36.1%), and the mandible (32.6%). Surgical intervention was necessary for 44.2% of patients, while 12.9% of cases underwent close reduction, and 42.9% did not require any surgical intervention. The occurrence of nasal bone fractures was significantly lower in cases where seat belts were worn and zygomatic arch fractures were less frequent in incidents with airbag deployment., Conclusions: In rollover crashes, the midface is the most vulnerable anatomical location. Utilization of seat belts and airbag deployment has the potential to prevent nasal bone and zygomatic arch fractures., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Maxillofacial Injury (MFI) is a major public health concern that is multifactorial in etiology-road traffic accidents (RTAs), falls and violence. RTAs are the major cause of maxillofacial injuries (MFIs) in countries like India. Recent studies have shown that maxillofacial fractures (MFF) constitute a significant proportion of facial injuries seen in hospitals (56.5%). The incidence of maxillofacial fractures can vary depending on several factors, including age, gender, and environmental factors. Of particular concern is the impact of seasonal variations, such as the monsoon season, which lead to high incidence of maxillofacial fractures due to hazardous conditions., Methods: A retrospective review of medical records was done in a tertiary-care dental teaching hospital was done., Results: Data of 200 subjects including 154 males (77%) and 46 females (23%) with a mean age of 35.38 ± 16.541 years; age range: 1 - 80 years was analyzed. A total of 200 MFI's were recorded between 2021 and 2022. Soft tissue injuries were reported in 37.5% of the cases in non-monsoon season and 42.3% of the cases during the monsoon season. Dentoalveolar fractures were reported in 6.2% of the cases during the non-monsoon seasons and 7.7% during the monsoon season. In this study, mandible was the most fractured bone (n=104,52%) followed by zygomatic complex (n=50, 25%). The frequently observed pattern among mandibular fracture was condyle 8.3% during the non-monsoon season and 2.9% during the monsoon season)., Conclusions: The results of the study indicate that mandibular fractures are most commonly seen in maxillofacial fractures, followed by fractures of the zygomatic complex. The study also reveals a higher incidence of soft tissue injuries and dentoalveolar fractures during the monsoon season. Further research is warranted to explore the factors that contribute to the seasonal variation in maxillofacial fractures for effective interventions to reduce their occurrence., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Shukla AD et al.)

Background/aim: This study aimed to analyze the frequency and pattern of maxillofacial injuries associated with domestic violence., Materials and Methods: Medical records of victims of domestic violence between May 2016 and May 2023 were scrutinized retrospectively. The following data were analyzed: gender and age, history of previous abuse, hospital admission, pregnancy, type of facial injuries, anatomical location of injuries, side of injuries, concomitant injuries, mechanism of impact, treatment modality, and history of drug and alcohol abuse., Results: Seventy-eight patients were included, comprising of 75 (96.2%) women and 3 (3.8%) men. Domestic violence was an etiology of 2.7% of all maxillofacial injuries. The mean age was 27.06 ± 5.5 years. 33.3% of cases had a history of previous domestic violence. The assailant was drug addicted in 47.4% of cases. The attacker was the current partner of the victim in 79.5% of the victims. Soft tissue injuries were found in 96.1% of cases. Maxillofacial fracture was observed in 52.6% of victims among which zygoma was the most common (16.7%) followed by the nose and mandible (15.4%). Isolated fracture was observed in 85.3% of patients and 71.8% of the injuries were observed on the left. Concomitant injuries were present in 51.3% of patients with arms/hands being the most frequent (48.7%). Punch (67.9%) constituted the majority of the mechanism of impact. Based on the statistical analysis, punches resulted in significantly higher soft tissue contusion (p = .046), and injuries that required no intervention were significantly higher in punched victims (p = .002)., Conclusion: Maxillofacial soft tissue injuries with or without isolated fracture on the left side of the zygoma, mandibular angle, or nose in association with arms/hands injuries in young adult women could be clues of domestic violence. Appropriate care such as preventive programs for drug or alcohol abuse should be implemented to reduce domestic violence, thereby reducing these injuries., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: The WHO, in its 2002 report, indicated the dramatic worldwide increase in the incidence of intentional injuries affecting people of all ages and both sexes, but especially children, women, and the elderly. The aim of this study was to analyze dental and maxillofacial injuries associated with domestic violence against women in Israel between the years 2011-2021., Methods: This was a retrospective cohort study based on data from the Israeli National Trauma Registry (INTR). The INTR provides comprehensive data on hospitalized patients from all six Level I trauma centers (TC) and 15 of the 20 Level II TCs in Israel. Women, ages 14 and older, injured and hospitalized due to domestic violence between 2011 and 2021 were identified., Results: Between 2011 and 2021, there were 1818 cases of women ages 14 + that were hospitalized due to violence, excluding terror, occupational trauma, and attempted suicide. Out of these injuries, 753 cases were attributed to domestic violence, 537 were defined as non-domestic violence and 528 were a result of a brawl/fight. Of the domestic violence cases, 5% (38) exhibited maxillofacial injuries compared to the non-domestic violence cases where 6.2% (33) exhibited maxillofacial injuries and the brawl group where 5.7% (30) exhibited maxillofacial injuries. The most injured areas in domestic violence cases were the maxilla followed by the zygomatic bone and the mandible. Almost half of the domestic violence cases (47.7%) required surgical intervention during their hospitalization. The spouse was the perpetrator responsible for the domestic violence in the majority of the cases., Conclusions: Dental professionals might be able, in some cases, to identify and report domestic violence signs and thus, better understanding of the specific characteristics of domestic violence related to traumatic injuries is important., (© 2023 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

Background: During the COVID-19 lockdown, more domestic violence-related traumas were reported. In this study, we investigated and compared the incidence of domestic violence-related injuries-in particular oral and maxillofacial injuries-in Ulaanbaatar, Mongolia, before and during the COVID-19 lockdown., Materials and Methods: We conducted a cross-sectional study based on 3974 domestic violence cases registered at the Public Health Department, National Traumatology and Orthopedics Research Center of Mongolia between 2018 and 2022. Descriptive and binary logistic regression analyses were conducted. The victims were categorized according to their age (child, adult, and elderly)., Results: The mean age of the victims was children 9.7 ± 5.4 years, adults 34.8 ± 8.3 years, and elderly 64.3 ± 8.7 years. Binary logistic regression analysis (no/yes) showed that oral and maxillofacial injuries during the lockdown increased 1.3 times (OR = 1.3; CI 95% = 1.0-1.6; p = .003) in adults and 2.5 times in children (OR = 2.5; CI 95% = 1.7-3.9; p = .001). Additionally, injuries to upper limbs increased 4.6 times (OR = 4.6; CI 95% = 3.5-6.1; p = .001) in adults and 5.2 times in elderly patients (OR = 5.2; CI 95% = 1.8-16.2; p = .01). Additionally, thorax injury in children increased 3.1 times (OR = 3.1; CI 95% = 1.7-5.7; p = .001)., Conclusions: During the lockdown, injury to oral and maxillofacial regions increased in adult and child victims of domestic violence., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: Maxillofacial trauma resulting from intimate partner violence (IPV) represents an important oral health problem. In this sense, the aim of this study was to investigate the spatial-temporal distribution of maxillofacial trauma resulting from IPV against women, using a geostatistical approach., Materials and Methods: An ecological study was carried out including the analysis of confirmed IPV cases against women treated at a Center for Forensic Medicine and Dentistry over a four-year observation period, as well as the evaluation of population data from the victims' places of residence extracted from the last demographic census of the Brazilian Institute of Geography and Statistics. Statistical analysis included: (i) finite mixture modeling to establish incidence trajectory patterns; (ii) Getis-Ord indicator (Gi*) for spatial autocorrelation; (iii) spatial regression analysis (p < .05)., Results: Two distinct trajectory patterns (TP1 and TP2) related to IPV incidence were identified using finite mixture modeling, suggesting spatial-temporal disparities at the regional level. In TP1, it was observed that IPV incidence was relatively low and remained stable over time, covering almost two-thirds (62.0%) of investigated spatial units. TP2 was characterized by higher IPV incidence with a tendency to increase in the last year, including more than one-third of neighborhoods (38.0%). Autocorrelation analysis showed a predominance of hot areas (hotspots) in the Eastern zone (p < .05) and in the Western zone (p < .05); and cold areas (coldspots) in the Northern zone (p < .05). In addition, statistically significant association was observed among neighborhoods with higher percentage of households with family householder without income and higher incidence of maxillofacial trauma resulting from IPV against women (β = 5.305; SE = 1.741; p = .002)., Conclusions: The findings indicate an association between higher IPV incidence against women, maxillofacial trauma, and socio-spatial vulnerability., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aims: Domestic violence (DV) encompasses a series of abusive behaviors, perpetrated in a family environment, against individuals of all ages and genders. Injuries to the head, neck, and face are frequent findings among victims of abuse, negatively impacting their quality of life. Although oral and maxillofacial injuries (OMFI) and traumatic dental injuries (TDI) are commonly diagnosed among DV victims, their prevalence is still unknown. This systematic review was aimed to assess the prevalence of OMFI and TDI among victims of DV., Methods: The protocol of the review was registered in PROSPERO (CRD42023424235). Literature searches were performed in eight electronic databases, up to August 7th, 2023. Observational studies published in the Latin-roman alphabet and reporting the prevalence of OMFI and/or TDI were included. The Joanna Briggs Institute's critical appraisal tool, checklist for prevalence studies, was used for quality assessment. Results were presented as qualitative and quantitative syntheses., Results: Seventeen studies, totaling 12,375 victims of domestic violence, were included. Meta-analyses showed an overall prevalence of 29% (95% CI: 15%-48%, I 2  = 99%) and 4% (95% CI: 1%-10%, I 2  = 98%) for OMFI and TDI, respectively. Higher pooled prevalence for OMFI (41%, 95% CI: 13%-46%, I 2  = 99%) was demonstrated in samples with only women. OMFI was less prevalent (20%) among DV victims under 18, while TDI was lower among adults (1%). Hospital samples presented higher pooled prevalence of OMFI (32%), and forensic data from fatal victims presented higher prevalence of TDI (8%)., Conclusion: The overall prevalence of OMFI and TDI in DV victims was 29% and 4%, respectively. Women victims of DV presented higher rates of OFMI (41%) and TDI (6%)., (© 2024 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

The nationwide extension of the electric scooter (e-scooter) scheme, which began in 2020, aimed to alleviate public transport congestion, to reduce pollution and peak-time road traffic. This retrospective study evaluates the range of e-scooter-related maxillofacial trauma before the recent scheme extension and compares the findings with existing literature on this topic. The Queen Elizabeth Hospital Birmingham, United Kingdom (UK) operates as a Level 1 Regional Major Trauma Centre and serves a population of four million. All patient records between September 2021 to September 2022 were analysed to establish the types of e-scooter-related maxillofacial trauma sustained. A Pearson's chi-squared test was used to assess for significant associations between variables recorded. Falls accounted for the majority of injuries (44.3%), and soft tissue lacerations were the most common maxillofacial injury (38%). Statistically significant results were measured in the following variables: gender and intoxication status (p = 0.007), helmet status and injuries sustained in maxillofacial and non-maxillofacial regions (p = 0.043), mechanism of injury and injuries sustained in both the maxillofacial and non-maxillofacial regions (p = 0.045). E-scooters are an emerging concern within the UK. Further studies across the UK are required to assess the frequency of e-scooter-related injuries. Such data may prove useful in determining the government's decision on e-scooter use on UK roads., Competing Interests: Conflict of interest We have no conflicts of interest., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Objectives: The objective of this study was to assess the patterns of maxillofacial injuries, aetiology and their management during the pandemic of Covid-19 in a tertiary care hospital in Lahore, Pakistan., Methods: This is a single center, prospective cross-sectional study. Patients from all age groups who presented at the Emergency room of Jinnah Hospital Lahore and managed by the Oral and Maxillofacial Surgery Department during 1st December 2020 till 31st January 2021 were included. Data were analyzed using IBM SPSS for Windows, Version 20.0., Results: Total 202 patient were analyzed, 161 (79.7%) were male and 41 (20.3%) were females. Male to female ratio was 4:1. About fifty three percent of patients belonged to the age group 15-35 years. The most common cause was road traffic accidents (RTA), followed by fall. Eighty-three (41.1%) had only soft tissue injuries without any bony fracture and 119 (58.9%) had facial bones fractures. Zygomatic bone fracture was most common (53.8%) followed by mandible fracture (31.1%). Sixty-one out of 119 patients with fractures were treated with Open Reduction Internal Fixation (ORIF). Three patients had complete loss of vision because of facial trauma. Only 56 (28%) patients were managed under General Anaesthesia., Conclusions: During the initial pandemic era, a large majority of patients presenting with maxillofacial injuries were young male adults. The most common cause of maxillofacial trauma was RTAs. Soft tissue injuries were predominant followed by facial bone fractures and zygomatic bone was more frequent among the fracture cases. Covid-19 pandemic increased the difficulties faced in the management of maxillofacial trauma patients.

Aim: This study evaluated records of patients with maxillofacial trauma due to interpersonal violence (IPV) being treated in the emergency room of a level I trauma center hospital in São Paulo, Brazil., Material and Methods: Data of patients with maxillofacial trauma due to IPV recorded between January 2019 and December 2019 were retrospectively examined. Personal data, days on which they experienced IPV, and the type of maxillofacial trauma sustained were extracted and statistically analyzed (p < .050)., Results: During the analysis, 1034 patients with maxillofacial trauma were identified; of these patients, 292 (28.2%) who experienced trauma due to IPV were included in this study. There was a mean age of 32.6 years and the most common type of trauma was soft tissue injuries (38.7%). Mandible and nose fractures were more prevalent in males and females, respectively. Our data, when compared with other studies on maxillofacial trauma due to IPV, showed a lower prevalence and male-to-female ratio, and a higher presence of dentoalveolar trauma. Additionally, our data when compared with studies on maxillofacial trauma due to other causes showed lower mean age and male-to-female ratios, and a higher occurrence of nose fractures differing from the predominance of mandibular fractures., Conclusion: Oral and maxillofacial surgeons must be able to suspect and identify cases due to IPV among their patients with trauma. With our results, although each case has its individuality, we can suggest that cases of maxillofacial trauma in young, female, and nasal fracture patients may be suspicious for IPV., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: The emergence of shared stand-up electric scooters has led to an increase in their usage and, subsequently, an increase in the incidence of maxillofacial trauma. This study aimed to investigate the trauma pattern associated with the use of stand-up electric scooters compared with that related to the use of bicycles, which was a popular mode of personal mobility before the emergence of stand-up electric scooters., Materials and Methods: This study investigated the medical records of patients who visited Wonju Christian Hospital for maxillofacial trauma due to the use of stand-up electric scooter and bicycles between November 1, 2017 and October 31, 2022. Maxillofacial trauma was analyzed based on medical records, including those in the evaluation results of teeth, maxillofacial bones, and soft tissues., Results: Crown fractures and tooth avulsions were observed more frequently with the use of stand-up electric scooters than with the use of bicycles. In contrast, crown-root fractures, tooth subluxation, and extrusive luxation were more commonly observed in bicycle riders. Additionally, the proportion of root fractures was similar between the two groups. However, no vertical root fractures were observed in patients who rode bicycles. The maxillofacial bone fracture rates between the two groups were similar, although the fracture patterns were different., Conclusion: The number of patients using stand-up electric scooters is increasing, and they are likely to have a worse prognosis compared with those using existing personal mobility devices., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: To analyze the epidemiology, pattern, and prevent measurement of pediatric maxillofacial trauma in Xinjiang, China., Patients and Methods: Clinical records of patients aged 0 to 18 years with maxillofacial trauma over the 5 years were reviewed. Epidemiological features of data were collected for the cause of injury, age and sex distribution, frequency and type of injury, localization and frequency of soft tissue injuries, facial bone fractures, and presence of associated injuries. Statistical analyses performed included descriptive analysis, χ 2 test, and logistic regression analyses., Results: Among the 450 patients, 333 were male and 117 were female, with a male-to-female ratio of 3.8:1, the mean age was 9.2±5.4 years; 223 cases were soft tissue injuries and 227 cases were maxillofacial fractures. The 16 to 18-year-old group was the highest, with the prevalence of maxillofacial fractures. The most common cause of pediatric maxillofacial trauma was traffic injuries., Conclusion: The incidence of maxillofacial trauma in pediatric patients correlates with a number of factors, including age, sex, and etiology of trauma. The 16 to 18-year-old group is the most prevalent group for maxillofacial trauma in pediatric patients, and traffic accidents are the leading cause of maxillofacial trauma in pediatric patients., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 by Mutaz B. Habal, MD.)

Maxillofacial injury is a common injury resulting from bicycle (including e-bike) and scooter accidents. With 80,000 admissions to emergency departments in 2019, bicycle accidents account for more than half of all traffic-related emergency department visits in the Netherlands. The United States reports approximately 130,000 injuries and 1000 fatalities related to cycling annually. This systematic review and meta-analysis was performed to examine the protective effect of helmets against maxillofacial injuries resulting from bicycle and scooter (including e-bike and e-scooter) accidents. After a systematic literature search, 14 studies were found to be eligible for this systematic review. Of these, 11 were included in the meta-analysis. None of the included studies focused on vehicles with motors (e-bikes and e-scooters); all focused only on non-motorized vehicles. All included studies were non-randomized, which could have led to bias in the pooled results. Data from the included studies were tested for heterogeneity using the binary random-effects model (DerSimonian-Laird method), and the odds ratio for the occurrence of maxillofacial injury in cyclists wearing a helmet versus those not wearing a helmet was calculated by random-effects meta-analysis. Patients who had worn a helmet suffered significantly fewer maxillofacial injuries than patients who had not, in bicycle accidents (odds ratio 0.682). In conclusion, wearing a helmet has a significant protective effect against maxillofacial injury, indicating the need for strict helmet legislation., Competing Interests: Competing interests None., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

To establish a set of variables that define a predictive profile of events of maxillofacial trauma resulting from interpersonal violence, we analyzed sociodemographic variables and clinical characteristics of injuries recorded in three tertiary care hospital centers in Chile. To assess the relation between categories, we applied a multiple correspondence analysis. We identified 567 cases. Two dimensions explained 53.4% of the model. The first dimension was composed of variables related to the severity of the injury: medical-legal prognosis (.574), type of trauma (.511), and the destination of the patient (.332); the second dimension was composed of variables related to the typology of interpersonal violence: type of violence (.398) and sex of the patient (.370). Two profiles were recognized: women, victims of domestic violence, with lesions affecting mainly soft tissues and not requiring hospitalization and men, victims of community violence, with lesions involving fractures associated with greater severity and requiring hospitalization. There are two key dimensions in the diagnosis of maxillofacial trauma resulting from interpersonal violence: severity of the injury and typology of the interpersonal violence. Exploring these predictive profiles can be a useful complement to the current screening tools of violence in clinical practice., (© 2023 Springer Publishing Company, LLC.)

Objectives: To determine the prevalence of maxillofacial fractures associated with persistent CSF leak, and to assess its bearing on clinical outcomes of consecutive patients managed at our centre., Methods: This was a retrospective cross-sectional study. The medical records of patients over 11-year period were analysed for age, gender, etiology of injuries, duration between injury and presentation to the hospital, types of facial fracture and their treatments, treatment done to control CSF leak, and complication(s). Descriptive and bivariate statistics were computed., Results: Overall, 1473 patients were evaluated, 66 (4.5%) presented with craniofacial injuries associated with persistent CSF leak after 5 days of non-surgical treatment. Males (92.5%, P= 0.0000) and those in the 21 to 30 years age group (59.1 %, P=0.01) were predominant. The most common (68.2%) type of fracture combination was Le Fort I, II and III, NOE, zygomatic complex and mandible. The commonest clinical presentation of CSF leak was rhinorrhea only, in 66.7% of patients (P= 0.001)., Conclusions: This study shows that the prevalence of maxillofacial fractures associated with persistent CSF leak was low, which was 4.5% of patients that presented with persistent CSF leak and 84.9% of the cases resolved after treatment of the various maxillofacial fractures., Competing Interests: The authors have no conflict of interest to declare. The authors claim to have no financial interests, either directly or indirectly, in the products or information listed in this article., (© 2023 Anyanechi CE et al.)

Background/aim: Owing to the nearly three-year-long COVID-19 pandemic, small personal transportation devices that allow for greater freedom of movement within the cities have gained attention. Therefore, the number of people using kick or electric scooters has increased. This study aimed to compare the characteristics of kick and electric scooter-related dental and maxillofacial trauma and provide helpful information for preventing scooter accidents, appropriate treatment of patients with scooter-related trauma, and policy establishment., Materials and Methods: This retrospective observational study analysed the medical records of 310 patients who visited the emergency room of Ajou University Dental Hospital for kick and electric scooter-related oral and maxillofacial injuries between 1 January 2017 and 31 December 2022. Sex, age, scooter type, time, and mechanism of the accident, helmet use, alcohol consumption, dental and maxillofacial injury types, and treatment were analysed., Results: The average age in the kick-scooter group (5.71 ± 4.25) was lower than that in the electric-scooter group (28.24 ± 10.02) (p < .0001). There were more males in both groups. The helmet usage rates of the two groups were 2.80% and 7.88%, respectively. In the kick-scooter group, periodontal damage was more common than pulp injury, while in the electric-scooter group, pulp injury was more common than periodontal injury. There was no significant difference in soft-tissue damage between the two groups; however, bone fractures occurred significantly more frequently in the electric-scooter group (p < .0001)., Conclusions: Electric scooters cause more crown and bone fractures than kick scooters and require more active treatment of dental and maxillofacial injuries. Riders should use protective equipment to prevent dental and maxillofacial injury. Although there are regulations related to scooters, the effectiveness of both kick- and electric-scooter related laws needs to be evaluated., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: The first objective of this study was to identify predictive factors for oral and maxillofacial fractures at the initial response to the patient. The second objective was to determine the factors influencing the incidence of treatment duration of more than 1 month using the information shown in the medical record., Materials and Methods: Hospital records from 2011 to 2019 were reviewed to identify patients who had sustained oral and maxillofacial injuries by falling or falling from a height. Patterns and types of oral and maxillofacial injury, injury severity, and background of the injury were collected from the hospital records. The variables independently associated with a treatment duration of more than 1 month were determined by logistic regression analysis., Results: In total, 282 patients (150 men, 132 women; median age, 17.5 years) were selected for analysis. Maxillofacial fractures were observed in 20.9% of patients (59/282); among these, mandibular fractures were the most common (47/59). Logistic regression analysis showed that age (odds ratio [OR], 1.026), nighttime occurrence (OR, 2.192), and upper face injury (OR, 20.704) were independent predictive factors for having a maxillofacial fracture. Additionally, the number of injured teeth (OR, 1.515) and the use of intermaxillary fixation (OR, 16.091) were independent predictors of treatment duration of more than 1 month., Conclusions: These results may be useful in the initial management of maxillofacial injuries in terms of better-informing patients injured by falling their expected treatment duration and managing the psychological impacts of a long treatment duration., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Maxillofacial skeleton is the most vulnerable site for trauma due to its prominence. The aim of our study was to analyse the cause and pattern of maxillofacial injuries & to correlate the aetiology and pattern of facial injury., Materials and Methods: This prospective study includes 304 patients with facial trauma, who reported to our institute within a time span of 2 years. Data were collected on basis of sociodemographic status plus additional data obtained on type of injury, aetiology, location and status of the victim., Result: The most frequent cause of maxillofacial trauma (MFT) was fall (43.3%) followed by RTA (34.2%) and assault (15.1%). In upper 3rd face region frontal bone fracture was prevalent with 1.3%, while in the midface, zygomatic complex (ZMC) fracture (3.9%) and in lower 3rd part of face, mandible fracture (42.8%) and dentoalveolar fracture (30.2%). Mandible was the most prevalent site for trauma. Although fall was the main aetiological factor in our study, midfacial injuries were mainly due to assault and RTA. Combination of mandibular fracture and soft tissue injury were mainly seen in RTA and injury due to fall. Conservative management was mainly employed for treatment with 46.1% followed by ORIF with 36.2%., Conclusion: Changing trend in aetiology of MFT was noted. Furthermore, study should be conducted for better understanding, and to carry out preventive measure for the same., (Copyright © 2024 Copyright: © 2024 Indian Journal of Dental Research.)

Aims: Children and adolescents who are affected by trauma may have complications that are more serious and dangerous. Herein, a meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies according to the geographic regions of the world among children and adolescents was conducted., Materials and Methods: A comprehensive search was performed in four databases of PubMed/MEDLINE, Web of Science, Cochrane Library, and Scopus from January 1, 2006 until July 7, 2021. To evaluate the quality of included articles, an adapted version of the Newcastle-Ottawa scale was used. The prevalence of maxillofacial trauma was estimated by event rates and 95% confidence intervals in relation to etiology and geographic region of study population., Results: Through search in the databases and the electronic sources, 3071 records were identified, and 58 studies were eligible for inclusion in the meta-analysis. A total of 264,433 maxillofacial trauma cases were reported by all included studies. Globally, the overall prevalence of maxillofacial trauma was highest due to Road Traffic Crashes (RTC) (33.8%) followed by falls (20.7%), violence (9.9%), and sports (8.1%) in children/adolescents. The highest prevalence of maxillofacial trauma were observed in African population (48.3%) while trauma due to falls was most prevalent in Asian population (44.1%). Maxillofacial trauma due to violence (27.6%) and sports (13.3%) were highest in North Americans., Conclusion: The findings demonstrate that RTC was the most prevalent etiology of maxillofacial trauma in the world. The prevalent causes of maxillofacial trauma differed between the regions of study population., (© 2023 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.)

Background: Maxillofacial injury is a major health problem, and injury patterns vary in different societies. The purpose of the present study was to evaluate the pattern of maxillofacial injuries presenting to BPKIHS., Methods: Patients with age >15 years presenting with maxillofacial injuries from May, 2019 to April, 2020 were included in this cross-sectional descriptive study. Demographic profile, etiology, delay in presentation, pattern of soft tissue/ bony/ dental injuries, treatment modality were recorded and analyzed using Microsoft excel., Results: Within one year study period 190 patients with age group >15 years presented with facial injuries. There were 164 male (86.32%) and 26 female (13.68 %) patients (M:F=6.3: 1) with mean age of 34.96 years. Road Traffic Accident (RTA) (61.58%) was the most common etiology. Majority of the patients reported to hospital within 2-6 hrs of injury. Other associated injuries was present in 36.32 % of patients with orthopedic injury (60.87%) being common. Soft tissue injuries were seen in 80.53% patients, of which 49.02% were associated with facial fractures. Mandible fractures were seen in 56.19% of hard tissue injuries, of which 40.68% had multiple fractures followed by 28.81% with parasymphysis fracture. Within 37.14% patients with midface fractures, zygoma fracture (33.33%) was the commonest. Intervention was done in 80.95 % patients, with ORIF (72.38 %) being the commonest. Dentoalveolar injuries was seen in 22.63 % patients, of which 48.19% were associated with facial fractures., Conclusions: Our observations show that motor vehicle accidents were the most frequent cause of maxillofacial injury.

Traumatic brain injuries (TBIs) associated with maxillofacial fractures (MFFs) are a public health concern worldwide, especially among adult-aged males. There is an urgent need for early detection of associated TBIs in patients with MFFs during the initial assessment and treatment stage to reduce morbidity and mortality. The objective of the present study was to systematically review the literature to determine specific MFF situations associated with TBIs and to identify the factors associated with TBIs in patients with MFFs. The protocol was developed in accord with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and was registered to the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42020155912. Overall, of 26,774 patients recorded, 13,667 patients (51.04%) sustained MFFs with an associated TBI. The male to female ratio was 4.8:1. RTA was the most common cause. The most common TBIs were concussions, contusions, and closed brain injuries. Within the limits of this study, it was concluded that TBI-related MFFs should be suspected whenever maxillary or mandibular bone fractures occur, especially among adults, males, and people with injuries caused by RTAs and assaults. There is a need to increase the awareness of maxillofacial surgeons on the possible associations of combined maxillofacial trauma and brain injuries., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Facial trauma in women is complex with physical, psychosocial, and cultural influences impacting clinical presentations. Although multifactorial, assaults and falls are principally reported as the main causes., Methods: A retrospective review was conducted from January 2012 to January 2017 at the Women and Children's Hospital and Royal Adelaide Hospital, Adelaide. All maxillofacial fractures in women that attended or were referred to the unit were included in this study. The primary objective was to analyse epidemiological trends of facial fractures and clinical outcomes in the South Australian female population., Results: There is a bimodal distribution of facial fractures at 25-35 years and 65 + years. Indigenous females were 19.5 years younger than non-indigenous females (30.5 vs 49.9, P < 0.001). Approximately half the cohort had a fall-related facial fracture, followed by assault (26.2%), and sports (10.3%). There was a higher proportion of non-alcohol-related trauma from assaults than alcohol-related assaults (72.5% vs 27.5%, P < 0.001). Over half (58.0%) of the cohort had a midface fracture. The elderly had increased odds of 1.9 fold for facial fractures in winter, largely from falls, compared to younger women. Associated injuries were present in almost half the elderly women with 2.6 times the risk compared to younger women. Younger women had higher incidences of surgical intervention (52.6% vs 14.3%, P < 0.05)., Conclusions: Young women disproportionately experience larger incidences of non-alcohol-related assaults requiring operative intervention of the mandible, whereas elderly women principally suffer fall-related facial fractures with higher rates of associated injuries., (© 2022. Crown.)

Background: The purpose of this retrospective cohort study is to investigate the incidence and treatment of maxillofacial fractures before, during, and after the COVID-19 pandemic., Material and Methods: This single-center study was conducted at King Abdullah University Hospital (KAUH). The required data was obtained from the electronic clinical records of all patients in whom maxillofacial fractures were confirmed by plain radiography and computed tomography (CT) between January 2019 and December 2021, allowing for a 12-month period before, during and after the COVID-19 pandemic., Results: During the study period, 595 maxillofacial fractures in 311 patients (234 males and 77 females, mean age 27.28 years) were treated. The most frequent affected age was 21-30 years old in the before and after COvid- 19 period (92 patients, 29.58.%), while in during-COVID-19 period it was 11-20 years old (22 patients, 7.07%). There was similarity in male predominance, RTA cause, anatomical site was the mandible, the type anatomical complexity was single, treatment procedure was ORIF in all three periods., Conclusions: The incidence of maxillofacial fractures during the COVID-19 pandemic period was lower compared to the periods before and after the pandemic. Given that most fractures were caused by RTAs, these findings are expected, as movement was restricted during lockdown.

Objective: Ice hockey players are at risk of a variety of injuries. In our investigation, we aimed to evaluate the types of facial fractures, injury mechanisms and need for surgical intervention in professional and recreational ice hockey players., Material and Methods: This retrospective study included all patients presenting to a tertiary trauma centre with any ice hockey-related facial fracture during the period from January 2013 to July 2020. The primary outcome variable was the need for surgical treatment, and the primary predictor variable was the injury mechanism. Demographic and clinically relevant variables were statistically evaluated and presented., Results: Of 66 total patients, the most frequent fracture type was isolated mandible fracture (56.1%). Males were overrepresented (98.5%) in the patient population. Puck strikes were the most common mechanism of injury (74.2%). Surgical intervention was performed in nearly half of the patients (48.5%), and was significantly more common in younger patients ( p  = 0.006). Associated dental injuries were present in 27.3% of the cases and they were significantly associated with puck strikes ( p  = 0.027)., Conclusions: Mandible fractures and puck strikes, the most common injury site and fracture mechanism respectively, sustained by ice-hockey players required surgical intervention in the majority of cases.

A literature review was performed to determine the frequency of medical evacuations (MEDEVAC) that are required for dental emergencies (DE) and oral-maxillofacial (OMF) injuries. Fourteen studies were reviewed altogether - eight which quantified evacuation of DEs or OMF injuries in military personnel (from 1982-2013) and six studies that discussed medical evacuation of DEs occurring in civilians working in offshore oil and gas rigs and wilderness expeditions (from 1976-2015). Among military personnel, DE/OMF issues were frequently among one of the top categories of medical evacuations, ranging from 2-16% of all evacuations. Among oil and gas industry workers, 5.3-14.6% of evacuations were dental-related, while one study of wilderness expeditions found that DEs ranked as the third most frequent type of injury that required evacuation. Previous studies have shown that dental and OMF problems often account for one of most frequently cited reasons for evacuation. However, due to the limited study base of DE/OMF medical evacuations, further research is needed to determine their impact on the cost of health care delivery., (2023.)

Maxillofacial injuries are a global problem in our modern society. It can be a major cause of increased morbidity and mortality. Maxillofacial trauma can lead to scar distortion accompanied by emotional and psychological problems. The epidemiology of facial fractures varies in terms of trauma type, the extent of injury, and severity. The main aim of this research is to explore the scope, the burden, and the etiology of maxillofacial injuries in Tbilisi, Georgia. Data was retrospectively collected from two large emergency departments in Tbilisi, Georgia using a cross-sectional design. Inclusion criteria was patients admitted in hospitals during one year with diagnosis maxillofacial injury. SPSS 21 software was used for statistical analysis. Differences in categorical variables were assessed with Chi-square tests of independence. This research shows that men are still the most frequent victims of maxillofacial injuries. Out of 598 patients, whose age ranged from 1month to 87 years - 67% were males, and 33% patients were females, including both, maxillofacial trauma alone and also combined injuries. With only maxillofacial injuries, the male patients were still leading, with 51% (307) and female patients were 28% (167), these results gave us a statistically significant difference (p=0.026). The main causes of maxillofacial injuries were falls, which equaled to 63% (378 patients) from total recorded data, as in many other countries. The results of this research provide really important information about future preventive interventions in the country. It also shows us that educating the public with prevention strategies is substantial.