![]() ![]() This evaluation was performed three times during each re-examination. Proper occlusion was an indicator that the skeleton was secure. ![]() During the application of downward force, patients were instructed to bite at the intercuspation position, and the degree of occlusion was evaluated. The midface skeleton was pulled downward at the incisor region and the second molar region using a constant amount of force, that is equivalent to the bite force for the same place by force meter (FG-5100, MRC Ltd). This procedure was repeated three times, the values were recorded, and a mean value was calculated ( 5).Įvaluation of midface skeleton stability: Patients were seated with a straight head and back posture and asked not to lean back against the wall so that the occlusal plane remained parallel to the floor. Patients were asked to bite the sensor of a bite force measurement device at the central incisor region and at the first molar region, holding the bit for 3–4 seconds with the occlusal plane parallel to the floor ( 4). Three examination time points were evaluated after dischargeīone stability was assessed by using a constant amount of force, that is equivalent to the bite force for the same place through force meter (FG-5100, MRC Ltd)Įvaluation of bite force: Patients were seated with a straight head and back posture and asked not to lean back against the wall. The third re-examination was conducted 1 month after discharge, and the all patients’ arch bars were removed from both jaws, and they were evaluated using the same examinations used at the first and second re-examination ( Figure 1). If the midface skeleton was unstable, the mandibulomaxillary fixation would be maintained to enhance stability. If the midface skeleton was stable, the mandibulomaxillary fixation could be removed. Firstly, second re-examination were conducted one week, two weeks after discharge, during which bone stability and bite force were evaluated. This study was performed prospectively, with three postoperative appointments, as follows. After the osteosynthesis, they underwent mandibulomaxillary fixation. All 31 patients who fulfilled the selection criteria underwent internal fixation, using at least zygomaticomaxillary buttresses with some cases that could not be bone grafting, such as severely comminuted fractures at the nasomaxillary buttress or nasofrontal buttresses. 19389 – ĐHYD).Īll patients were subjected to clinical examination, photographic assessment, and radiological examinations (computed tomography imaging with three-dimensional views). This study was approved by the Ethics Committee of Biomedicine Study of University of Medicine and Pharmacy at Ho Chi Minh City (No. Informed written consent was obtained from all patients. ![]() Patients with collapsed bones, fractures with large defective areas, unidentifiable intercuspation position due to excessive teeth loss, or previous treatment for Le Fort I or Le Fort II fracture or mandibular fracture at the other healthcare facilities were excluded from this study. This study was performed on 31 patients diagnosed with Le Fort I or Le Fort II fracture at the Department of Maxillofacial Surgery, National Hospital of Odonto-Stomatology in Ho Chi Minh City, Vietnam, from August 2019 to June 2020. However, in some cases, such as in severely comminuted fractures, mandibulomaxillary fixation may improve maxillary immobilization, particularly in cases in which internal plates achieve inadequate fixation ( 3). Open reduction and internal fixation using plates and screws can enhance the stability and correction of anatomic structures, improving the recovery of bite forces and bite function. Therefore, the clinical characteristics of these fractures must be properly and accurately evaluated to determine the optimal treatment strategy. Midfacial fractures are associated with complicated clinical characteristics, causing severe deformations after the injury, resulting in sequelae that include malocclusion, convex facial structure, displaced eyeballs, or nerve injuries ( 2). The increasing complexity of traffic accidents has resulted in an increase in the numbers of Le Fort I and Le Fort II fractures cases, in addition to an increase in the number of total maxillary fracture cases. Phillips et al.’s study on 6989 Le Fort fractures showed that there were 1132 cases (16%) with diagnosis of Le Fort I fractured and 1305 (19%) with Le Fort II fractures ( 1), respectively. ![]()
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