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Introduction: Facial trauma deserves prompt attention because of its enormous functional and cosmetic importance. Aim of the study was to study the causes and treatmentof patients admitted with Zygomatic fractures and to evaluate the pattern for surgicaltreatment. To highlight on the indications for closed and open reduction. Material and Methods: This is a prospective study which was done on 32 patients over a period of 20 months. Patients with isolated zygomatic fractures, both sexes and all age groups were included. Results: This study encompassed a total number of 32 patients with Zygoma fractures 30(96.15%) patients were Male and 2 (3.85%) patients were Female with Male to Female ratio of 26:1. Most common age group involved in this study was 20-30years (57.69%). Most common risk factors identified in this study was Road traffic accidents which accounted for majority of the cases (83%) followed by interpersonal violence cases (10%) and accidental falls (7%). In our study out of 32 Zygomatic bone fractures. The most prevalent fractures were on right side. In our study the commonest presenting feature is subconjuctival haemorrhage (92%) followed by circum orbital echymossis (90%), Trismus (61%), malar flattening (60%) and numbness in the infra orbital nerve distribution (5%). In our study 18 patients underwent closed reduction by Gilles method and 10 patients underwent open reduction and internal fixation with miniplates and screws. 2 patients were treated with both Gilles elevation and ORIF. Zygomatic Arch fractures were 18 and Zygomatic comlex fractures were 12 Single point fixation was done in 17 patients at Zygomaticomaxillary buttress and 3 patients had 2 point fixation at ZygomaticoMaxillary and Zygomatico Frontal sutures. Single point fixation in the ZM area in Zygomatic complex fractures can avoid unsightly scars and give high satisfaction with surgical outcomes in selected patients with fracture displacement. Conclusion: It was concluded that the high frequency of Zygomatic fractures due to RTA in our population highlights the need for the strict enforcement of traffic rules and regulations. In view of the avoidable morbidity and mortality due to inadequate treatment, we advocate the establishment of regionalized, efficient, and focused trauma centers in various parts of the state particularly for acute trauma. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methodology Results Conclusion Road traffic accidents have significantly impacted public health in Vietnam. This study investigated the patterns of midface fractures in Vietnam and their correlation with road traffic accidents in the country.This retrospective cross‐sectional study reviewed 2187 medical records of patients with midface fractures in Ho Chi Minh City. After applying exclusion criteria, the fractures were categorized. Statistical analyses, including chi‐squared and logistic regression, were conducted to identify associations and relationships among the types and causes of fractures.The study found that 89.3% of midface fractures stemmed from road traffic accidents, with 55.2% and 14.4% zygomatic complex fractures and Le Fort type II fractures, respectively. Adults aged 19–39 accounted for 65.1% of patients, with males at 80.5%. Traffic accidents were significantly associated with an 18.7 times higher risk of concomitant mandibular fractures and a 10.5 times higher risk of Le Fort type II fractures, irrespective of age and gender.This study underscores the need for targeted prevention strategies to decrease the incidence of maxillofacial injuries resulting from road traffic accidents in Vietnam, particularly among high‐risk groups such as males and young adults. [ABSTRACT FROM AUTHOR]

Facial or maxillofacial trauma occurs as a consequence of physical injury to the face and can include damage to soft tissue and bony structures either in isolation or combination. There is a male predominance with highest incidence in the age group of 20–40 years. The range of injuries include soft tissue damage, bruising, lacerations, burns and fractures of the underlying facial skeleton including the zygomatic complex, mandible, maxilla, orbit and nasoethmoidal complex. The concentration of special senses in the head and neck region means that even seemingly minor injuries can have a significant impact upon the long-term outcome for a patient. Careful assessment of an injured patient must include a full ATLS evaluation to ensure that associated potentially life-threatening injuries are not missed. This article describes the signs, symptoms and treatment of maxillofacial trauma, including management of hard and soft tissue trauma. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic spread rapidly worldwide, including in Indonesia. As a result, people developed a fear of visiting hospitals and a tendency to ignore symptoms unrelated to COVID-19. A zygomaticomaxillary complex bone fracture is one of the most frequent midface fractures and is often accompanied by infraorbital nerve paresthesia. Purpose: This article aims to report two cases of neglected zygomaticomaxillary complex bone fractures with persistent infraorbital nerve paresthesia caused by the patient's fear of seeking medical care. Cases: The first case is a 19-year-old male with a history of trauma two weeks prior to hospital admission. He was diagnosed with a neglected zygomaticomaxillary complex bone fracture, which resulted in persistent infraorbital nerve paresthesia. This condition was due to the patient's fear of visiting the hospital. The second case is a 21-year-old female who presented with a history of persistent numbness on the left cheek and upper lip for one month prior to hospital admission. The symptoms originated from an accident where the patient fell from a ladder measuring two meters in height. Case management: Surgical intervention--open reduction and internal fixation (ORIF)--was performed on both patients to promote nerve recovery. However, there is ongoing debate regarding the safety of elective oral maxillofacial surgery procedures during the COVID-19 pandemic. After a follow-up period, both patients experienced a recovery of sensory function in the infraorbital nerve. Conclusion: Infraorbital nerve sensory disturbance along with zygomaticomaxillary complex bone fracture found during the COVID-19 pandemic should be managed with ORIF to improve nerve recovery. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic spread rapidly worldwide, including in Indonesia. As a result, people developed a fear of visiting hospitals and a tendency to ignore symptoms unrelated to COVID-19. A zygomaticomaxillary complex bone fracture is one of the most frequent midface fractures and is often accompanied by infraorbital nerve paresthesia. Purpose: This article aims to report two cases of neglected zygomaticomaxillary complex bone fractures with persistent infraorbital nerve paresthesia caused by the patient’s fear of seeking medical care. Cases: The first case is a 19-year-old male with a history of trauma two weeks prior to hospital admission. He was diagnosed with a neglected zygomaticomaxillary complex bone fracture, which resulted in persistent infraorbital nerve paresthesia. This condition was due to the patient’s fear of visiting the hospital. The second case is a 21-year-old female who presented with a history of persistent numbness on the left cheek and upper lip for one month prior to hospital admission. The symptoms originated from an accident where the patient fell from a ladder measuring two meters in height. Case management: Surgical intervention—open reduction and internal fixation (ORIF)—was performed on both patients to promote nerve recovery. However, there is ongoing debate regarding the safety of elective oral maxillofacial surgery procedures during the COVID-19 pandemic. After a follow-up period, both patients experienced a recovery of sensory function in the infraorbital nerve. Conclusion: Infraorbital nerve sensory disturbance along with zygomaticomaxillary complex bone fracture found during the COVID-19 pandemic should be managed with ORIF to improve nerve recovery.

Purpose: The purpose of this study was to analyse Gillies Temporal approach Vs Towel Clip method for reduction of zygoma fractures. Method: A randomised comparative study was conducted on 30 patients having zygoma fractures confirmed with pre-operative NCCT face with 3 D reconstruction. Patients were divided into 2 groups, Group-1- Gillies temporal approach and Group-2- Towel clip method. Clinical observations were recorded in a predesigned proforma for all the patients and analysed statistically. Results: Gillies Temporal Approach significantly p < 0.001 took longer time for reduction than Towel Clip Method. Post-operative pain was experienced more in Group 1 than Group 2. Intraocular pressure was compared at different time intervals and significant difference was noted. Also, Occulocardiac reflex was observed in Group 1. Mean trismus index was 16.87 ± 5.12 mm in Group 1 and 13.33 ± 4.11 mm in Group 2 preoperatively which significantly increased to 51.93 mm in Group 1 and 51.73 mm in Group 2 one month post-op. Reduction was maintained post-operatively with good quality of outcome in both the groups. Conclusion: Non-comminuted zygomatic complex fractures can be effectively treated using Towel Clip Method as this method is cost-effective, minimally invasive, safe, causing minimum or no damage to soft tissue and easy to perform based on surgeon's skill and requires less operating time, proving it equally efficient method with excellent aesthetic outcomes. [ABSTRACT FROM AUTHOR]

Background: The zygomatic region stands out as the most prominent facial portion, and zygomatic complex fractures (ZMC) are the second most prevalent facial fractures in the lateral mid-face area. This study investigated the associations between fractures in the ZMC and injuries to the infraorbital nerve at a tertiary care hospital. Methods: This cross-sectional study was conducted among 72 patients from September 2021 to March 2022, at the Oral and Maxillofacial Surgery Department, Jinnah Post Graduate Medical Centre, Karachi. Patients aged between 16 to 65 years, recently diagnosed with zygomatic bone fractures, were included in the study through consecutive non-probability sampling. Comprehensive patient histories, including demographic information, gender, age and residential status, obesity, and the identification of infraorbital nerve injuries diagnosed through clinical examinations and radiographic assessments. SPSS vr20 was used and the Chi-Square test was utilized to explore associations between categorical variables. Results: Among the 72 cases, 45(62.5%) were male, while 27(37.5%) were females. The average age was 37.43 ± 11.04 years, with ages ranging from 16 to 65 years. Within this cohort, 47(65.3%) individuals were residents of urban areas, whereas 25(34.7%) hailed from rural regions. Notably, positive infraorbital nerve injuries were detected in 54 patients (p=0.02), constituting 75.0% of the total injuries. Among those with ZMC fractures, 25(34.7%) (p=0.02) also had infraorbital injuries, while 20(27.8%) (p=0.03) did not exhibited such injuries. Conclusion: our study highlights a noteworthy correlation between ZMC fractures and infraorbital injuries. These results underscore the reciprocal relevance of assessing infraorbital injuries in ZMC fracture cases and vice versa, enhancing the comprehensive understanding and management of such injuries in clinical practice.

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. [ABSTRACT FROM AUTHOR]

The study aims to assess the safety and effectiveness of BoneTape™, a new resorbable bone fixation device, using a zygomatic fracture model in rabbits. The study followed BoneTape™ samples and control (sham) groups over 2-, 6-, and 12-week periods post-zygomaticomaxillary (ZM) osteotomy and zygomaticofrontal (ZF) disarticulation. The osteotomized segments were analyzed for bone healing, inflammatory response, and tissue healing. µCT imaging and histological analysis were used to examine the axial alignment, offset, and quality of new bone formation. BoneTape™ samples demonstrated enhanced maintenance of the initial intraoperative positioning, reduced axial offset, and better alignment when compared with the control group, enabling stable bone healing under physiological loading conditions. Complete union was observed at 12-weeks in both groups. The BoneTape™ group experienced minimal immune and tissue reactions, classically associated with wound healing, and showed an increased number of giant cells at 6 and 12-weeks. BoneTape™ represents a promising advancement in osteosynthesis, demonstrating efficacy in maintaining stable zygomatic reconstruction and eliciting minimal immune response in a rabbit model. This study introduces BoneTape™ as a disruptive solution specifically designed for clinical application in cranio-maxillofacial fracture fixation, with the potential to eliminate the use of over-engineered solutions while offering benefits such as ease of application and fewer biologically disruptive steps. [ABSTRACT FROM AUTHOR]

Subciliary incision is a common approach for facial fracture surgery; however, it has a higher incidence of lower lid ectropion, which can be particularly challenging for beginning surgeons to manage. This study reports the usage of lateral tarsoplasty combined with a full-thickness skin graft (FTSG) to correct severe ectropion following the subciliary approach for infra-orbital rim fractures. We retrospectively reviewed all facial fracture cases involving infra-orbital rim fractures through a subciliary approach treated in our department between March 2021 and May 2023. Electronic medical records and clinical digital photographs of patients who met the inclusion criteria were reviewed. After reviewing 196 cases that used the subciliary approach, we found 6 patients (3.06%; 4 males and 2 females; mean age, 68.5 ± 4.89 years) with postoperative severe ectropion managed using lateral tarsoplasty and FTSG. The mean ectropion development and correction times after facial fracture surgery were 0.78 ± 0.24 and 0.91 ± 0.37 months, respectively. At the 12-month follow-up, all patients showed favorable outcomes, and the position of their lower eyelids was well maintained without ectropion recurrence. Based on these successful outcomes, lateral tarsoplasty combined with FTSG is proposed to be an effective and straightforward method for managing lower eyelid ectropion caused by facial fracture surgery. [ABSTRACT FROM AUTHOR]

Standard treatment for full rehabilitation of compromised maxillae with regular implants includes sinus elevation grafting, a minimum of two to three surgeries, and a minimum treatment time of 9 to 15 months. Zygomatic implants are a viable alternative. However, prosthetic restorations have been compromised due to abutments emerging on the palate. The purpose of this study was to find ways that abutments will emerge on the ridge (occlusal surface). The presented results show it can be done if zygomatic implants are placed in the sinus wall (extra-sinus) and use an internal, conical connection with platform-switching and 45-degree abutments. Thus, marginal tissue prognosis and primary stability may also be improved by adding coronal threads to an implant design. These improvements, if confirmed in longer follow-ups and further studies, may encourage more graftless rehabilitations of severely compromised maxillae, reducing the number of surgeries and overall treatment time. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: One-point fixation was superior to the two and three-points fixation in minimally displaced zygomaticomaxillary complex (ZMC) fracture regarding the cost, invasiveness, scaring, number of wounds, and operation time. Accordingly, this study aimed to predict which one-point fixation is the most stable in managing minimally displaced ZMC fracture. Material & methods: This study simulated the different one-point fixation approaches on three ZMC models after fracture reduction and application of all forces exerted on the fractured area. The findings were represented as stress impact on the ZMC fracture and plating system as well as the inter-fragments micro-motion. Results: The von misses stresses of plates for the zygomaticofrontal, infra-orbital rim, and zygomaticomaxillary buttress model were (66.508, 1.285, and1.16 MPa) respectively. While the screws' von misses for the infraorbital rim, zygomaticofrontal, and zygomaticomaxillary buttress models were (13.8, 4.05, and 1.60 MPa) respectively. Whereas, the maximum principles stress at zygomaticofrontal, zygomaticomaxillary buttress, and infraorbital rim models were (37.03, 37.01, and 34.46 MPa) respectively. In addition, the inter-fragment micro-motion for zygomaticomaxillary buttress, infraorbital rim, and zygomaticofrontal models were (0.26, 0.25, and 0.15 mm) respectively. Conclusion: One-point fixation at zygomaticomaxillary buttress is the preferred point because it is exposed to low stresses, and the inter-fragment micro-motion is within the approved limit with the elements in the same direction of fixation which indicates the rigid fixation. In addition, it is less palpable and scarless. Trial registration: clinical trial.gov (NCT05819372) at 19/04/2023. [ABSTRACT FROM AUTHOR]

Zygomaticomaxillary complex fractures are very common in maxillofacial trauma and may be associated with fractures of the coronoid process. We report a case of dislocation of the coronoid process above a zygomaticomaxillary complex fracture locking the mandible. We also report the surgical management of this uncommon case and its follow-up. [ABSTRACT FROM AUTHOR]

Introduction: Orbital wall fractures that may develop in maxillofacial traumas (MFTs) may cause ophthalmic complications (OCs). The aim of this study is to determine the frequency of orbital fractures (OFs) accompanying MFTs and findings suspicious for orbital traumatic involvement. Materials and Methods: Computed tomography (CT) images of 887 patients who presented to the emergency department within a 1-year period with a history of MFT were retrospectively scanned. During the examination, patients with orbital wall fractures, craniofacial bone fractures, and posttraumatic soft tissue changes were recorded. Results: OF was observed in 47 (5.3%) of the patients admitted for MFT. In cases with OFs, accompanying nasal (25.5%), ethmoid (2.1%), frontal (19.1%), maxillary (38%), and zygomatic bone fracture (10.6%), sphenoid (4.3%), and soft tissue damage (55.3%) were observed. It was observed that the pathologies mentioned at these levels were significantly higher than in patients without orbital involvement (p < 0.05). In our study, mild (48.9%) and moderate-severe (2.12–4.25%) OCs accompanying OFs were observed after MFT. Conclusions: The frequency of MFT varies depending on various factors, and such studies are needed to take preventive measures. Knowing the risk and frequency of orbital damage accompanying MFTs may help reduce complications by allowing rapid and accurate diagnosis. [ABSTRACT FROM AUTHOR]

Background. The zygomatic complex is the second most common fracture of the facial bones after the nasal bone. The prominent convex shape of the zygoma makes it vulnerable to traumatic injury. Diplopia is one of the serious complications of zygomatic complex fracture and is a common subjective complaint. Objective. To determine the frequency of diplopia in zygomatic complex fractures. Methodology. A cross-sectional descriptive study was conducted at the Oral and Maxillofacial Surgery Ward, Civil Hospital, Karachi, Pakistan. The duration of the study was 1 year (March 1, 2021 to February 28, 2022). A total of 126 patients having zygomatic complex fractures were included in this study. After recording the patient's complete history, like demographic details and cause for fracture, diplopia was examined clinically. If, during the examination, the patient complained of double vision, this was labeled as diplopia positive (Yes) and negative (No) if the patient did not have any such complain. Data were statistically analyzed. Results. The mean (±SD) age of patients was 33.42 (±9.27), with 91 (72.2%) male patients and 35 (27.8%) female patients. The frequency of diplopia in zygomatic complex fractures was observed in 52 (41.3%) patients. The rate of diplopia was significantly high in patients aged between 31 and 40 years (P-value = 0.0005). Conclusion. The frequency of diplopia among patients having zygomatic complex fractures was high in this study. Thus, forming a strategy to properly diagnose and treat it and to prevent persistent morbidity to improve patient's quality of life is recommended. [ABSTRACT FROM AUTHOR]

Among the traumas, those that affect the oral and maxillofacial region stand out considerably, due to their high complexity and the fact that they affect a bodily region with great physiological, aesthetic and social importance. This study aimed to characterize the facial traumas that generate fractures, specifying their distribution and etiology, in patients who were hospitalized. For this, a cross-sectional study was carried out on secondary data, in which 407 medical records of patients hospitalized by the Oral and Maxillofacial Surgery Service of the public network at Hospital da Restauração Governador Paulo Guerra - HR, in the city of Recife-Pernambuco, were collected, from which 130 medical records were selected whose reason for admission into the hospital was trauma to the bones of the face, hospitalized in the period between January 1st and December 31st, 2021, representing the sample of this study. The results regarding the distribution of fractures showed that the mandible was the most affected bone (66% of the cases), followed by the maxilla with 35%, the zygoma with 29%, the orbit with 15% and the bones of the nose in 12%. As for the etiology, car accident was responsible for the highest frequency of fractures with 29%, followed by physical aggression, with 22%, Firearm Projectile (16%), falls (16%), others (10%). It can be concluded that, in the period studied, the mandible was the most affected bone by fractures and traffic accidents were the main causes of facial fractures requiring hospitalization, and men being five times more affected than women. [ABSTRACT FROM AUTHOR]

Introduction: Midface fracture incidence and trauma patterns vary across countries, due to socioeconomic, environmental, and cultural factors. The aim of this retrospective study was to assess the etiology, pattern, and treatment of midface fractures in North of Jordan during 2018–2021. Methods: This single-center retrospective study was based on the review of the medical records of patients who had suffered midface fractures and were treated at the Department of Oral and Maxillofacial Surgery at the King Abdullah University Hospital. The dataset for this investigation spanned the 4-year period from January 2018 to December 2021. Results: During the 4-year period, 267 patients presented with 376 different maxillofacial fractures. Of those, 140 patients had 250 midface fractures, with a mean of 1.79 per patient. Their age ranged from 2 to 68 years (mean [standard deviation] = 25.8 [12.0] years). The most frequent injury cause was road traffic accidents (RTA) (n = 72, 51.3%), followed by falls (n = 27, 19.3%). Among midface fractures, the most frequent were orbit fractures (42.4%), followed by zygomatic fractures (31.6%) and maxillary fractures (26%). The majority of fractures (77.9%) were treated through open reduction and internal fixation (ORIF), while the remaining (15.7%) required closed reduction and conservative treatment was sufficient in 6.43% of fractures. Conclusions: Midface fractures were more common among males, and primarily occurred in the orbital floor due to the high incidence of RTAs. Maxillary fractures were mostly of the LeFort I Type and ORIF was the most common treatment modality. [ABSTRACT FROM AUTHOR]

Patients with moderate to severe atrophic maxilla challenge the surgeon to discover alternative ways to use existing bone or resort to augmenting the patient with autogenous or alloplastic bone materials. Many procedures have been suggested for these atrophied maxillae before implant placement, which include Le Fort I maxillary downfracture, onlay bone grafts and maxillary sinus graft procedures. A zygomatic implant can be an effective device for rehabilitation of the severely resorbed maxilla. If zygomatic implants are used, onlay bone grafting or sinus augmentation will not be necessary. The purpose of this paper is to review the indications of zygomatic implants placement techniques, stabilization, and prosthodontic procedures. [ABSTRACT FROM AUTHOR]

Purpose: To assess the postoperative complications and outcome (implant survival) of quad zygomatic implants inserted in patients with edentulism and severely atrophic maxillae. Materials and Methods: Two independent reviewers conducted an electronic search of the literature (PubMed, Scopus, EBSCO, Web of Science) from January 2000 to February 2019. The inclusion criteria were articles published in English reporting data of at least five patients with severely atrophic edentulous maxillae undergoing placement of four zygomatic implants without additional insertion of standard implants, with a minimum of 6 months of follow-up. Data extracted included number of patients, characteristics of the maxillary defect, number of zygomatic implants, implant details, surgical procedure, prosthetic rehabilitation, postoperative complications, survival rate, and length of follow-up after definitive prosthesis delivery. Results: Eleven studies with 166 patients were included. The heterogeneity among studies was not significant. The pooled incidence rates of complications were as follows: sinusitis 12% (95% confidence interval [CI]: 4% to 23%), malposition and surgical guiding failure 11% (95% CI: 3% to 21%), local infection/injury 10% (95% CI: 3% to 18%), and prosthetic complications 5% (95% CI: 0% to 13%). The implant survival rate ranged between 95.8% and 100%, and the pooled implant survival rate in the meta-analysis was 98% (95% CI: 97% to 99%). Conclusion: Quad zygomatic implants inserted in patients with severely atrophic edentulous maxillae have a high implant survival rate, but the incidence of complications should not be underestimated. [ABSTRACT FROM AUTHOR]

Background: Many approaches have been suggested for management of zygomaticomaxillary fractures. Each approach has its own advantages and limitations. Aim of this study: The study is intended to compare between the subtarsal approach, conventional transconjuctival approach and the Y- modification of the transconjuctival approach in the management of zygomatico-maxillay complex fractures. Materials and methods: Twenty-four patients with age range of 20–50 years requiring open reduction and fixation of a fractured zygomatic complex were randomly divided into three equal groups. Group A: subtarsal approach group, group B: a conventional transconjunctival approach group and group C: Y- modification of the transconjunctival approach group. Intraoperative and postoperative parameters were evaluated. Results: As for the exposure time, group C had the longest duration. Easy access to the site of fracture was reached in all groups with no statistically significant difference. During the first 24 h, the pain was only statistically significant between groups A and B with higher pain level in group A. After the first week, pain was significantly higher in groups A and C, with respect to group B. The least edema was observed in group B after 24 h, one week and four weeks postoperatively. Regarding ocular complications, wound healing and sensory nerve function, there was no statistically significant difference between the groups. Scarring was only noticeable in group A patients. Conclusion: The transconjunctival approach provides adequate exposure with excellent esthetics and minor complications. The Y-modification also delivers an esthetic access with inconspicuous scar to the frontozygomatic region. Trial registration: The trial has been registered on clinicaltrials.gov (ID: NCT05695872). [ABSTRACT FROM AUTHOR]

Gillies method is widely used for zygomatic arch fractures. Many modifications were suggested over time but Gillies method is still carry on popularity. Seventeen patients with isolated zygomatic arch fractures who were treated with Gillies method between 2016 and 2021 were included in this study. All patients were male and the mean age was 23 years (20–32). All operations were performed under sedation anesthesia. All patients healed uneventfully. Only one transient frontal branch of facial nerve paralysis was seen in the follow-up. Etiology of zygomatic arc fractures were sports injury in 9 patients (53%), motorcycle accident in 3 patients (17.6%), assault in 3 patients (17.6), and sencop in 2 patients (11.7%). Zygomatic arch fractures were located on left zygomatic arch in 13 patients (76.5%), right zygomatic arch in 4 patients (23.5%). Eleven patients (64.7%) were operated in 1 week and 6 patients were operated on the second week (35.3%) after the injury. We think that Gillies method is still very useful in the treatment of isolated zygomatic arch fractures. Level of evidence: Level V, Therapeutic study. [ABSTRACT FROM AUTHOR]

Introduction: Zygoma fractures are common injuries due to their prominent nature and proper treatment is important to achieve functional and esthetic results. Anatomical reduction and plate fixation are crucial in the treatment of zygomatic fractures. However, there is no consensus on the optimal treatment. Therefore, we aimed to analyze the surgical treatment results and outcomes of surgical treatment results. Materials and Methods: Data were obtained from the hospital registry system. Age, sex, concomitant diseases, smoking history, etiology, type of fracture, accompanying fractures, methods used for treatment, complications, length of hospital stay, and time from diagnosis to surgery were retrospectively recorded. SPSS version 26.0 was used for data analysis. Results: There was no statistically significant difference between the types of fractures seen in traffic accidents, falls, and assaults, which are the most common causes of etiology (P = 0.14). No statistically significant difference was observed between the number of plates used for fixation and the presence of complications (P = 0.90). However, the incidence of complications was significantly higher in patients with at least one fixed plate than in those without (P = 0.017). Conclusion: High-energy Types B and C injuries are more common in surgically treated zygoma cases. Based on our analyze, we believe that open anatomical reduction is most important step in treatment. Plate fixation should be preferred when it is necessary to maintain stability. [ABSTRACT FROM AUTHOR]

Introduction: Orbital fractures constitute one of the common injuries of the maxillofacial region. They may occur either as isolated fractures, as blowout fractures, or as part of the more complex zygoma fractures. The management of orbital fractures has always been a challenging task for oral and maxillofacial surgeons in terms of access, perfect alignment, and fixation. Only a few randomized prospective studies have compared the incisions, according to a meta-analysis on incisions for orbital floor exploration. Hence this study was undertaken, and all the parameters affecting the choice of the incision were evaluated and compared between the incisions, which were not available in other comparative studies such as scleral show and chronic lid edema. Materials and Methods: This comparative randomized study was conducted on 30 patients with zygomatic maxillary complex fractures or isolated infraorbital rim fractures in whom open reduction and internal fixation of the infraorbital rim was planned. The patients were divided into three groups randomly, with 10 patients in each group. In Group I, patients were treated with subciliary incision, in Group II with subtarsal incision, and in Group III with infraorbital incision. Results: The infraorbital incisions produced the most visible scar, followed by the subtarsal (P = 0.002). The subtarsal and infraorbital incisions provided very good exposure to the fracture site compared to the subciliary (P = 0.004). Statistics revealed that the relationship between the scleral scar and the incisions was not statistically significant six months postoperatively (P = 0.355). The subciliary incision had a higher chance of ectropion. Discussion and Conclusion: The infraorbital incision was less time consuming, but it had the disadvantage of a visible scar and chronic lid edema. The subciliary approach had an imperceptible scar but had higher chances of scleral show and ectropion. Hence, in conclusion, the results of the current study suggest that the subtarsal approach is superior compared to the subciliary and infraorbital approaches as it combines the advantages of the subciliary and subtarsal approaches with minimal complications. [ABSTRACT FROM AUTHOR]

Introduction. Zygomatic bone fractures are prevalent in the maxillofacial region. This study aims at analyzing the epidemiology and clinical presentation of isolated zygomatic bone fractures. Material and Methods. The retrospective study, conducted at the Clinic of Maxillofacial Surgery of the University Clinical Center of Vojvodina, included 128 patients diagnosed with isolated zygomatic bone fractures. The following parameters were taken into consideration: gender, age, trauma etiology, clinical presentation, computed tomography analysis of the fracture localization and pattern. The fractures were classified into five groups according to Zingg classification system. Results. The study included patients aged 10-82 divided into four groups, with the most affected group being 30-49 years old. Men were more often treated for zygomatic bone fractures (male: female ratio 3:1). Left-sided fractures of the zygomatic bone occurred more often (55.2%) than the right-sided ones. Type B was the most common type of fracture, while the zygomaticomaxillary buttress fracture was the most common injury. Early treatment was administered in 78 patients (60.94%), while 50 patients (39.06%) underwent delayed reconstruction. The analysis of complications concerning the time of surgical intervention revealed a higher incidence of ectropion in cases treated early, while infraorbital paresthesia and facial asymmetry were more prevalent in cases treated late. Conclusion. Zygomatic bone fractures have high morbidity risk, and may cause temporary incapacity to work, and potentially permanent and functional damage. [ABSTRACT FROM AUTHOR]

Introduction: Reduction of zygomaticomaxillary (ZMC) fracture is often difficult to evaluate intraoperatively because of it peculiar anatomy and limited accessibility. The purpose of this study is to evaluate the efficacy of use of C-arm as a tool for intraoperative monitoring of ZMC fracture reduction. Materials and Methods: Group I (C-Arm) and Group II (control group) comprised of patients with isolated unilateral displaced Zygomatic complex (ZMC) fractures and having orbital volume change. The efficacy of use of C-arm intra-operatively was evaluated to analyse the reduction of fracture. Results: It was observed that mean change in ocular volume was around 1.07cm2 for Group I and 1.51cm2 in Group II. Thus post-operative eye volume was near to normal in Group I than Group II. The change in ocular volume post-operatively was observed to be statistically significant (p-value < 0.05) in both the groups. Post HOC Tukey statistical analysis determined the intergroup relation in change in eye volume between normal, pre- and post-operative and was found to be statistically significant (p-value < 0.05). The intergroup comparison between Group I and Group II was done using ANOVA statistical analysis and was found to be statistically significant (p-value < 0.05). Discussion: Our study revealed that C-arm is definitively an effective tool in the oral and maxillofacial surgery armamentarium, giving better results with minimal surgical exposure and by eliminating operator related error. [ABSTRACT FROM AUTHOR]

Introduction: The consumption of alcoholic beverages reduces the body's ability to deal with dangerous situations and exposes people to trauma. Objective: To determine the association between the consumption of alcoholic beverages and the characteristics of maxillofacial fractures treated at a Cuban university hospital in the context of COVID-19. Material and Methods: An observational, analytical, and cross-sectional study was carried out in the Maxillofacial Surgery unit at the “Carlos Manuel de Céspedes” General University Hospital during the year 2020. Prevalence ratios, 95% confidence intervals and p-values were obtained using generalized linear models. Results: In 58.23% of the cases, fractures were related to the consumption of alcoholic beverages. The fundamental etiology was interpersonal violence (47.75%), regardless of the consumption of alcoholic beverages. There was a prevalence of patients with nasal fractures (n=98; 55.06%), among which, 35.71% had consumed alcoholic beverages at the time of the trauma. Being male (p=0.005), the lack of university studies (p=0.007), the need for surgical treatment (p

Background: The aim of this study was to determine the epidemiological pattern of maxillofacial fractures in northwestern China by retrospectively analysing the demographics, aetiologies, concomitant injuries, fracture sites, and management. Methods: A 10-year retrospective analysis of 2240 patients with maxillofacial fractures admitted to the General Hospital of Ningxia Medical University was conducted. The extracted data included sex, age, aetiology, fracture site, concomitant injuries, time of treatment, therapeutic approaches and complications. Statistical analyses were performed, including descriptive analysis and the chi-square test. Logistic regression was used to determine the impact factors of maxillofacial fractures and concomitant injuries. P values < 0.05 were considered statistically significant. Results: The age of the included patients ranged from 1 to 85 years, and the mean age was 35.88 ± 15.69 years. The male-to-female ratio was 3.9:1. The most frequent aetiology of maxillofacial fractures was road traffic accidents (RTAs) (56.3%), and the most common fracture sites were the anterior wall of the maxillary sinus, arcus zygomaticus and mandibular body. A total of 1147 patients (51.2%) were affected by concomitant injuries, with craniocerebral injury being the most common. Logistic regression analyses revealed increased risks of mid-facial fractures in elderly individuals (odds ratio (OR) = 1.029, P < 0.001) and females (OR = 0.719, P = 0.005). Younger patients had a higher risk of mandibular fractures (OR = 0.973, P < 0.001). RTAs increased the risk for mid-facial fractures and high falls increased the risk for mandibular fractures. Conclusions: The maxillofacial fracture pattern is correlated with sex, age and aetiology. Patients were mainly young and middle-aged males, and the main cause of injury was RTAs, mostly causing compound fractures. Medical staff must be systematically educated to comprehensively examine patients with injuries resulting from RTAs. The management of patients with fractures requires thorough consideration of the patient's age, aetiology, fracture site, and concomitant injuries. [ABSTRACT FROM AUTHOR]

The repair and reconstruction of defects in the craniomaxillofacial region can be particularly challenging due to the complex anatomy, individuality of each defect, and sensitivity of the involved systems. This study aims to enhance the facial appearance and contribute to the reconstruction of the zygomatic arch. This was achieved through virtual planning of the surgery and assessment of clinical matching, including orbital measurements and registration of numerical models. A three-dimensional design of a young female case was generated on a skull model using Mimics® software, and the orbit was isolated using 3-Matic® to assess the reconstructive effect. 3D-printed implants were then surgically placed on the injured region, and Netfabb® software was used to make a virtual registration between the numerical models before and after the intervention. This allowed for the calculation of a deviation of 7 mm, equivalent to 86.23% of the shape restoration rate, to assess the success of the surgery. The computerized method enabled a precise design of the needed plates and analysis of the fixation places, resulting in a satisfactory cosmetic and functional outcome for the patient with minimal complications and good implant stability. Notably, a significant difference was observed in the orbital frontal area after 3 months of surgery (p < 0.001). Within the limitations of the study, these results suggest that virtual planning and customized titanium implants can serve as useful tools in the management of complex zygomatic-orbital injuries. [ABSTRACT FROM AUTHOR]

Background: Complex orbital fractures are impure orbital fractures because they involve the orbital walls and mid-facial bones. The author reported an orbital wall restoration technique in which the primary orbital wall fragments were restored to their prior position in complex orbital fractures in 2020. As a follow-up to a previous preliminary study, this study retrospectively reviewed the surgical results of complex orbital wall fractures over a 4-year period and compared the surgical outcomes by dividing them into groups with and without balloon restoration. Methods: Data of 939 patients with facial bone fractures between August 2018 and August 2022 were reviewed. Of these, 154 had complex orbital fractures. Among them, 44 and 110 underwent reduction with and without the balloon technique respectively. Pre- and postoperative Naugle exophthalmometer (Good-Lite Co.) scales were evaluated. The orbital volume and orbital volume ratio were calculated from preoperative and 6 months postoperative computed tomography images. Results: Among 154 patients with complex orbital fractures, 44 patients underwent restoration with the balloon technique, and 110 patients underwent restoration without it. The Naugle scale did not differ significantly between the two groups, but the orbital volume ratio significantly decreased by 3.32% and 2.39% in groups with and without the balloon technique and the difference in OVR was significantly greater in patients in the balloon restoration group compared with the control group. Postoperative balloon rupture occurred in six out of 44 cases (13.64%). None of the six patients with balloon rupture showed significant enophthalmos at 6 months of follow-up. Conclusion: The balloon rupture rate was 13.64% (6/44 cases) with marginal screw fixation, blunt screws, and extra protection with a resorbable foam dressing. Furthermore, we restored the orbital wall with primary orbital fragments using balloon support in complex orbital wall fractures. [ABSTRACT FROM AUTHOR]

Even for the most skilled maxillofacial surgeon, gaining access to the zygomatic arch for surgical procedures can be difficult due to the potential obstruction caused by a depressed zygomatic arch fracture, leading to restricted mouth opening. There are various treatment options available for zygomatic arch fractures. This article discusses the deep subfascial technique as a means to access the Temporomandibular Joint (TMJ) and zygomatic arch. This surgical procedure ensures a secure operative field while minimizing the risk to facial nerve branches. Here, the authors present the case of a 62-year-old male patient who sustained a right zygomatic arch fracture in a road traffic accident. The fractured segments were treated surgically through open reduction and internal fixation using the deep subfascial approach. The procedure resulted in minimal post-operative discomfort, no functional impairment, successful reduction of the fracture, and restoration of function. [ABSTRACT FROM AUTHOR]

Background Orbital blowout fractures are peculiar injuries causing disruption of both ocular function and symmetry. We present our experience with the use of a precontoured titanium mesh in orbital blowout fractures. Methods A retrospective study of patients undergoing correction of orbital blowout fractures with a precontoured titanium mesh was done at a tertiary care center in Mumbai. Data regarding demographics and pre- and postoperative clinical and radiological attributes were retrieved and compared. Results A total of 21 patients (19 males and 2 females) underwent correction of blowout fractures with a precontoured titanium mesh. The follow-up period ranged from 6 to 10 months. Road traffic accident (76%) was the most common etiology. Twenty (95%) patients had impure blowout fractures and 1 (5%) patient had a pure blowout. The orbital floor was most commonly fractured (16 [76%]). Associated fractures of the zygomaticomaxillary complex were found in 71% of patients. All patients were operated on within 3 weeks of trauma. A comparison of the operated and uninjured sides on coronal views of computed tomography (CT) scan in nine patients by Photopea application revealed a correction of the increased cross-sectional area in all cases. Enophthalmos was completely corrected in 94% patients, while 92% patients had complete correction of diplopia. One patient with a comminuted zygomatic fracture had persistent diplopia and mild enophthalmos. Infraorbital paresthesia persisted in 58% patients at 6 months of follow-up. No significant postoperative complications were noted. Conclusion The precontoured titanium mesh restores orbital wall anatomy and is safe, quick, fairly easy, and reproducible with a shorter learning curve. With proper patient selection and execution, prefabricated titanium mesh can serve as an excellent reconstructive option in blowout fractures of the orbit. [ABSTRACT FROM AUTHOR]

Background: When performing reduction of zygomatic arch fractures, locating the inward portion of the fracture can be difficult. Therefore, this study investigated the discrepancy between the locations of the depression on the soft tissue and bone and sought to identify how to determine the inward portion of the fracture on the patient's face. Methods: We conducted a retrospective review of chart with isolated zygomatic arch fractures of type V in the Nam and Jung classification from March 2013 to February 2022. For consistent measurements, a reference point (RP), at the intersection between a vertical line passing through the end point of the root of the ear helix in the patient's side-view photograph and a transverse line passing through the longest horizontal axis of the external meatus opening, was established. We then measured the distance between the RP and the soft tissue depression in a portrait and the bone depression on a computed tomography (CT) scan. The discrepancy between these distances was quantified. Results: Among the patients with isolated zygomatic arch fractures, only those with a fully visible ear on a side-view photograph were included. Twenty-four patients met the inclusion criteria. There were four types of discrepancies in the location of the soft tissue depression compared to the bone depression: type I, forward and upward discrepancy (7.45 and 3.28 mm), type II, backward and upward (4.29 and 4.21 mm), type III, forward and downward (10.06 and 5.15 mm), and type IV, backward and downward (2.61 and 3.27 mm). Conclusion: This study showed that discrepancy between the locations of the depressions on the soft tissue and bone exists in various directions. Therefore, applying the transverse and vertical distances measured from a bone image of the CT scan onto the patient's face at the indicated RP will be helpful for predicting the reduction location. [ABSTRACT FROM AUTHOR]

The 3D modeling of orbital bones in facial CT images is essential to provide a customized implant for reconstructions of orbit and related structures during surgery. However, 3D models of the orbital bone show an aliasing effect and disconnected thin bone in the inter-slice direction because the slice thickness is two to three times larger than the pixel spacing. To improve the inter-slice resolution of facial CT images, we propose a method based on a 2D convolutional neural network (CNN) that uses the spatial information on the sagittal and axial planes and the orbital bone edge-aware (OBE) loss. First, intermediate slices are generated on the sagittal plane. Second, the generated intermediate slices are transformed to an axial image, which is then compared with the original axial image. To generate intermediate slices with an accurate orbital bone structure, the OBE loss considering the orbital bone structure on the sagittal and axial planes is used. To improve the perceptual quality of the generated intermediate slices, the feature map difference loss is additionally used on the axial plane. In the experiment, the proposed method showed the best performance among bilinear and bicubic interpolations, 3D SRGAN, and a 2D CNN-based method. Experimental results confirmed that the proposed method can generate intermediate slices with clear edges of thin bones as well as cortical bones on both the sagittal and the axial plane. [ABSTRACT FROM AUTHOR]

Background: The second most frequent site for face bone fractures is the zygomatic arch. Because of its anatomical prominence, zygomatic bone fractures are becoming more common. Since the fracture lines cannot be seen clearly in closed reduction, the fragments are clinically repositioned using digital exploration and crepitus noise or traditional radiography imaging as a guideline. Objectives: The aim of this study to evaluate the accuracy of zygomatic arch reduction by using of portable wireless dental X-ray with an intraoral sensor. Methodology: This study comprised 15 patients who had isolated zygomatic arch fractures. The study was conducted between February 2021 and September 2022 in the department of oral and maxillofacial surgery at Alwasity Teaching Hospital, with patients ranging in age from 21 to 43. All cases were treated by closed reduction with the use of portable wireless dental X-ray with an intraoral sensor to ensure the reduction intraoperatively. Results: Three months postoperatively all patients were sent for a new CT scan, we found excellent reduction and bone healing at the fracture site, except only one case was reveal slight depression at the fracture site but was esthetically accepted. Conclusion: intraoperative use of portable wireless dental X-ray with an intraoral sensor is considered a safe, relatively easy, reliable method in the treating of zygomatic arch fracture. [ABSTRACT FROM AUTHOR]

Background: The purpose of the present study was to analyze the etiology, incidence, pattern, and treatment modalities of patients with maxillofacial fractures treated at the Department of Dentistry of a medical college in Pondicherry during the period between June 2011 and June 2019. Materials and Methods: A retrospective epidemiological study of 277 patients treated for maxillofacial fractures between June 2011 and June 2019 was performed. Data regarding age, gender, etiology, site of the fracture, time of injury, presence of associated injuries, treatment modalities, and complications were recorded. Results: A total of 491 maxillofacial fractures were seen in 277 patients. These were 261 males (94.2%) and 16 females (5.8%) with a male to female ratio of 16.3:1. Most of the patients 79.8% were in the age group of 11 to 40 years. Most common cause of injury was Road Traffic Collisions (RTCs; 62.1%), followed by fall (20.2%), assault (14.4%) and others (3.3%). Fractures of the mandible (52.3%) and zygomatic complex (18.9%) were the most common maxillofacial fractures reported in our study. 196 patients sustained associated injuries with a prevalence of soft tissue injury (61.2%). Majority of fractures were treated with open reduction and internal fixation (ORIF; 71.9%) of patients followed by closed reduction (17.7%) and observation only (10.4%). Postoperative complications were presented in 16.8% of the patients in the study. Conclusion: RTC is the commonest cause of maxillofacial injury with a male predominance in our study. Mandibular and zygomatic complex fractures were the most common. ORIF remains the preferred method of treatment. [ABSTRACT FROM AUTHOR]

Oral and Maxillofacial Surgery (OMFS) is among the newest established medical specialties and its full scope is not fully known by other specialties. The aim of the present study is to record the perception of OMFS scope by general medical practitioners (GMPs) of the National Health Service in Greece. A cross-sectional study was conducted in GMPs via a structured questionnaire. Questions involved various head and neck disorders and possible referring medical specialties. 66 answered questionnaires were included in this study. Participants were established to regional health practices, health centres or hospitals. 77.2% of the participants would refer a facial laceration to a plastic surgeon and only 7.2% to an OMFS. 89.3% would refer a zygoma fracture to an OMFS and 10.6% to an ENT. The vast majority would refer a tongue cancer, a neck mass and a mouth lesion to an ENT (74.8%, 81.8%, and 48% respectively). OMFS scope awareness of GMPs can be considered low. Thus, widening the knowledge of OMFS practice in primary grade medical practitioners is of high importance. Early exposure of medical students to the specialty could be a valid option to achieve this target. [ABSTRACT FROM AUTHOR]

Background: To compare the sensory change and recovery of infraorbital area associated with zygomaticomaxillary and orbital floor fractures and their recoveries and investigate the factors that affect them. Methods: We retrospectively reviewed 652 patients diagnosed with zygomaticomaxillary (n= 430) or orbital floor (n= 222) fractures in a single center between January 2016 and January 2021. Patient data, including age, sex, medical history, injury mechanism, Knight and North classification (in zygomaticomaxillary fracture cases), injury indication for surgery (in orbital floor cases), combined injury, sensory change, and recovery period, were reviewed. The chi-square test was used for statistical analysis. Results: Orbital floor fractures occurred more frequently in younger patients than zygomaticomaxillary fractures (p< 0.001). High-energy injuries were more likely to be associated with zygomaticomaxillary fractures (p< 0.001), whereas low-energy injuries were more likely to be associated with orbital floor fractures (p< 0.001). The sensory changes associated with orbital floor and zygomaticomaxillary fractures were not significantly different (p= 0.773). Sensory recovery was more rapid and better after orbital floor than after zygomaticomaxillary fractures; however, the difference was not significantly different. Additionally, the low-energy group showed a higher incidence of sensory changes than the high-energy group, but the difference was not statistically significant (p= 0.512). Permanent sensory changes were more frequent in the high-energy group, the difference was statistically significant (p= 0.043). Conclusion: The study found no significant difference in the incidence of sensory changes associated with orbital floor and zygomaticomaxillary fractures. In case of orbital floor fractures and high-energy injuries, the risk of permanent sensory impairment should be considered. [ABSTRACT FROM AUTHOR]

Fractures of the zygoma are rarely encountered in pediatric patients. This report presents a case of a 3-year-old child who presented with a vertically split fracture of the marginal tubercle of the zygoma. The marginal tubercle, a bony portion present on the posterior border of the frontal process, assists in attaching the temporalis fascia. This patient was treated surgically with bony fixation using tissue glue. To the best of our knowledge, no cases of fracture of the marginal tubercle of the zygoma have been reported in the literature. Fractures of the marginal tubercle of the zygoma in pediatric patients may be overlooked because of their anatomic location and the musculoskeletal characteristics of these patients. Here, we discuss the clinical features of marginal tubercle fractures of the zygoma. [ABSTRACT FROM AUTHOR]

The incidence of head injury in maxillofacial trauma patients varies widely in the literature. A good understanding of the patterns of association between these injuries would aid in efficient multidisciplinary treatment. The aim of this study therefore was to understand the associations between head injury and facial trauma by retrospectively analysing the records of patients seen at a tertiary care trauma centre. Demographic data were also described. Records of 4350 facial trauma patients over a five-year period were reviewed. A total of 3564 (81.9%) patients were victims of motor vehicle accidents (MVA). Male patients predominated, comprising 3711 (85.3%), and 36.6% were in the third decade of life. Facial fractures were seen in 2120 (48.7%), the most common being zygomatic fractures (60%). At the time of trauma, 2383 (57.3%) patients were under the influence of alcohol, and 2821 (87.8%) victims of two-wheeler MVAs were not using their helmet. Of all patients, 29.75% sustained a traumatic brain injury (TBI). Midface fractures were strongly associated with TBI. Maxillofacial injury may be considered a risk factor for TBI, and as such should immediately be suspected and investigated in all patients. Prompt recognition and management can improve outcomes in these patients. [ABSTRACT FROM AUTHOR]