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      The role of prosthetic, orthodontic and implant-supported rehabilitation in the management of secondary malocclusion to maxillofacial trauma- A systematic review

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          Abstract

          Purpose

          Different approaches have been proposed to treat malocclusion secondary to the treatment of maxillofacial trauma. This study aimed to investigate the efficacy of prosthodontic treatment, orthodontic treatment, and implant-supported rehabilitation for the management of secondary malocclusion after maxillofacial trauma.

          Study selection

          We searched five electronic databases and hand searched eight journals. The types of studies included were randomized controlled trials, cohorts, case–controls, and case series with at least eight patients with maxillofacial trauma and postoperative malocclusion. These studies used prosthetic treatment and implant-supported rehabilitation for secondary malocclusion after maxillofacial trauma. Risk of bias of eligible studies to be included in the final analysis was assessed independently by two authors using a tool for methodological quality assessment and synthesis of case series and case reports.

          Results

          After initial screening and identification of titles and abstracts, full text of 44 articles were found and evaluated against inclusion criteria. Of these 42 articles were excluded and remaining two were included in the review. Both the studies were case series with moderate to high risk of bias.

          Conclusions

          Both prosthetic treatment and implant-supported rehabilitation have the potential to restore secondary malocclusion after maxillofacial trauma. However, because less number of well-designed studies with high risk of bias were included in this systematic review, the findings should be interpreted with caution. Well-designed high-quality studies are required to draw definitive conclusions.

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          Most cited references17

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          Methodological quality and synthesis of case series and case reports

          Case reports and case series are uncontrolled study designs known for increased risk of bias but have profoundly influenced the medical literature and continue to advance our knowledge. In this guide, we present a framework for appraisal, synthesis and application of evidence derived from case reports and case series. We propose a tool to evaluate the methodological quality of case reports and case series based on the domains of selection, ascertainment, causality and reporting and provide signalling questions to aid evidence-based practitioners and systematic reviewers in their assessment. We suggest using evidence derived from case reports and case series to inform decision-making when no other higher level of evidence is available.
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            Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study.

            The aim of this study was to assess the characteristics of maxillofacial fractures in the Piracicaba region of Brazil during a 5-year period and to delineate comparisons with worldwide facial fracture patterns. A descriptive statistical analysis was developed based on data collected using a specifically designed clinical survey of all patients who attended the Division of Oral and Maxillofacial Surgery at the Piracicaba Dental School from 1999 to 2004. Information regarding age, gender, etiology, and type of maxillofacial injury and its associated lesions were evaluated. In addition, treatment modalities and complication rates during patient follow-up were assessed. A total of 1024 patients presenting 1399 maxillofacial fractures were analyzed. Patients' ages ranged from 0 to 88 years (mean age, 28 +/- 16.4 years). The ratio of men to women was 4:1. Most fractures were caused by traffic accidents (45%), followed by assaults (22.6%), falls (17.9%), sports accidents (7.8%), and work accidents (4.5%). The prevalent anatomic regions of facial fractures (in percentages) were the mandible (44.2%), the zygomatic complex (32.5%), and the nasal bones (16.2%). Associated systemic lesions were found in 41.9% of patients, with prevalence for injuries to the upper (24.1%) and lower limbs (15.4%). Patient management was considered to be conservative in 490 patients (47.9%), and surgical therapy was performed in 493 patients (48.1%), of whom 399 (80.9%) were treated with open reduction and rigid internal fixation. Complications occurred in 76 patients (7.4%), mainly due to infection and malocclusion. The findings of this study indicated that epidemiological research of maxillofacial fractures allows the presentation patterns of the most affected individuals and the nature of their lesions to be outlined according to the region evaluated. Furthermore, treatment evaluation and complication rate analysis permits a more realistic interpretation of how patients should be managed.
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              • Abstract: not found
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              The epidemiological analysis of maxillofacial fractures in Italy: The experience of a single tertiary center with 1720 patients

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                Author and article information

                Contributors
                Journal
                Saudi Dent J
                Saudi Dent J
                The Saudi Dental Journal
                Elsevier
                1013-9052
                1658-3558
                16 December 2020
                May 2021
                16 December 2020
                : 33
                : 4
                : 177-183
                Affiliations
                Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, United Arab Emirates
                Author notes
                [* ]Corresponding author at: Preventive and Restorative Dentistry Department, College of Dental Medicine, Building M28, University of Sharjah, Sharjah, UAE. kkhalaf@ 123456sharjah.ac.ae
                Article
                S1013-9052(20)30808-7
                10.1016/j.sdentj.2020.12.004
                8117368
                a4001c0c-821a-486e-9ebf-7317acde9afc
                © 2020 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 20 July 2020
                : 1 December 2020
                : 6 December 2020
                Categories
                Review Article

                prosthetic,orthodontic,implant-supported rehabilitation,management,secondary malocclusion,maxillofacial trauma

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