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Bite force measurement in mandibular parasymphyseal fractures: a preliminary clinical study.

ABSTRACT: We measured the amount of bite force generated by patients treated for parasymphyseal fractures of the mandible by open reduction and internal fixation at various predetermined time intervals. Sixty volunteers ranging from 18 to 60 years old were selected as the control group. All measurements were made on a bite force measurement device with the head in an upright position and in an unsupported natural position. Bite forces were measured at the incisor and right and left molar regions. These bite forces were compared with six patients with isolated mandibular unilateral parasymphyseal fractures. All patients were operated using open reduction and internal fixation using two miniplates at the fracture site. In the volunteer group, bite forces ranged from 22 to 50 kg in the molar region and 3 to 27 kg in the incisor region. Mean adult healthy values (male and female) in the molar region were 36 kg and in the incisor region, 15 kg. In mandibular parasymphyseal fractures, incisor bite forces were reduced significantly when compared with the control group in the first 2 postoperative weeks and regained significantly thereafter till 4 to 6 weeks. Bite forces in the molar region took ~6 to 12 weeks to regain maximum bite forces when compared with the volunteer group. Restoration of functional bite forces was evident by 6 to 8 weeks. However, the restoration of maximum bite forces may require up to 12 weeks in parasymphyseal fractures.

SUBMITTER: Kshirsagar R

PROVIDER: S-EPMC3314259 | biostudies-other | 2011 Dec

REPOSITORIES: biostudies-other

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Project description:As the mandible is susceptible to fracture, the aim of this study was to use multivariate logistic regression analysis to identify and distinguish various internal factors that may influence the location of mandibular fractures. The study included 1131 patients with maxillofacial fractures during the period from January 2000 to December 2009 to evaluate the association of mandibular fracture location (unilateral symphysis, body, angle, condylar, or bilateral condylar fractures) with various internal factors. Among the 1131 patients, 869 had mandibular fractures. Data on age, sex, soft tissue injuries, dental trauma, and maxillofacial fracture type were collected and analyzed using multivariate logistic regression. In total, 387, 210, 139, 319, and 172 patients were diagnosed with unilateral symphysis, body, angle, unilateral, or bilateral condylar fractures, respectively. The dental trauma in patients with bilateral condylar fractures differed from that in patients with unilateral condylar fractures. Patients with mandibular fracture (unilateral symphysis, body, unilateral or bilateral condylar) possessed an approximately equal risk of soft tissue injuries in the mandible. Patients with either unilateral or bilateral condylar fractures were associated with a low risk of mandibular angle fracture (OR < 1). Similarly, patients with mandibular angle fracture were associated with a low risk of unilateral or bilateral condylar fractures (OR < 1). Moreover, patients with symphysis fracture were associated with a low risk of bilateral condylar fractures (90 of 387 [23.3%], OR 0.899). By contrast, patients with bilateral condylar fractures were associated with a high risk of symphysis fracture (90 of 172 [52.3%], OR 17.38). Patients with condylar fractures, particularly those with bilateral condylar fractures, were infrequently associated with secondary mandibular fractures. Mandibular fractures tended to have less of an association with midfacial fractures. The occurrence of mandibular fractures is strongly correlated with age, sex, soft tissue injuries, dental trauma, and the pattern and position of the maxillofacial fractures in patients.

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Bite force measurement in mandibular parasymphyseal fractures: a preliminary clinical study.

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