DOI:

10.37988/1811-153X_2022_1_66

Post-traumatic mandibular deformation due to untimely medical treatment

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Authors

  • M.S. Malykh 1, 2, postgraduate at the Maxillofacial surgery and general dentistry Department; maxillofacial surgeon
    ORCID ID: 0000-0003-3448-7243
  • R.V. Mellin 1, 2, postgraduate at the Maxillofacial surgery and general dentistry Department; head of the Maxillofacial and reconstructive plastic surgery Division, chief external maxillofacial surgeon of the Republic of Khakassia
    ORCID ID: 0000-0002-1587-0581
  • K.A. Sivolapov 1, PhD in Medical Sciences, full professor of the Oral and maxillofacial surgery and General dentistry Department
  • Yu.L. Vasil’ev 3, PhD in Medical Sciences, full professor of the Operative surgery and topographic anatomy Department
    ORCID ID: 0000-0003-3541-6068
  • 1 Novokuznetsk State Institute for Advanced Medical Training, 654005, Novokuznetsk, Russia
  • 2 Republican Clinical Hospital, 655012, Abakan, Russia
  • 3 Sechenov University, 119991, Moscow, Russia

Abstract

According to various authors, the number of patients with injuries of the maxillofacial region in relation to the total number of injuries ranges from 3.2 to 8%. Among the complications that accompany patients with post-traumatic deformities, it is possible to determine the pathology of the bite, a violation in the structure of the temporomandibular joint, adaptation disorder and cognitive impairment. Goal — clinical case presentation of post-traumatic deformity of the mandible on both sides, due to untimely seeking medical help and a defect in the provision of medical care.
Materials and methods.
Patient P. was beaten by an unknown person on the night of 05.12.2021 to 05.13.2021, on this occasion he was immediately taken to the emergency room at the department of maxillofacial surgery. After a clinical examination, he was hospitalized with Ds: Bilateral fracture of the mandible between teeth 3.4, 3.3 and tooth 4.8 with displacement. Due to the patient’s refusal from surgical treatment, it was decided to resort to a combined method of treatment, including the removal of the tooth 4.8 from the fracture gap, splinting according to Tigerstedt, followed by fixation of a small fragment on the right with a Kirschner wire according to the Donskoy method.
Results.
08.19.2021 patient was re-admitted to the department of maxillofacial surgery with Ds: Post-traumatic deformity of the mandible at the level of the 3.3 tooth and in the right angle. During the examination, a bone step was determined in the projection of the 3.3 tooth with a large fragment slightly displaced upwards and outwards. Tight pathological mobility of fragments. Mobility of the tooth 3.3 of the II degree, percussion is painless. A bone step is also determined in the retromolar area on the right with a small fragment shifted up to 1 cm. There is no pathological mobility of fragments. Percussion of the tooth 3.7 is painless, there is no mobility. Under endotracheal anesthesia, tooth 3.3 was removed from the fracture gap, refracted on both sides, and the fragments were fixed with titanium plates Conmet (Russia) under bite control.
Conclusion.
It is necessary to develop a unified algorithm for providing assistance and determine the optimal timing of surgical intervention, taking into account the severity of the patient’s condition.

Key words:

post-traumatic deformation, mandibular fracture, maxillofacial surgery

For Citation

[1]
Malykh M.S., Mellin R.V., Sivolapov K.A., Vasil’ev Yu.L. Post-traumatic mandibular deformation due to untimely medical treatment. Clinical Dentistry (Russia).  2022; 25 (1): 66—72. DOI: 10.37988/1811-153X_2022_1_66

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Received

January 31, 2022

Accepted

March 5, 2022

Published on

March 1, 2022