International Journal of Preventive and Clinical Dental Research

ORIGINAL ARTICLE
Year
: 2018  |  Volume : 5  |  Issue : 4  |  Page : 50--52

A clinical study of incidence, etiology, and pattern of mandibular fractures in K. R. Hospital, Mysore


S Sandeep Tejaswi1, TS Subash2,  
1 Resident Surgeon, Department of Dentistry, K. R. Hospital, Mysore, Karnataka, India
2 Head of the Department, Department of Dentistry, K. R. Hospital, Mysore, Karnataka, India

Correspondence Address:
Dr. T S Subash
Department of Dentistry, K. R. Hospital, Mysore, Karnataka
India

Abstract

Introduction: The mandible is the second-most common fractured part of the maxillofacial region after the nasal bone. The incidences, etiology, and pattern of mandibular fractures vary considerably among the different population; there is a need to evaluate aspects of mandibular fracture in Mysore. The main causes of mandible fractures in this study are road traffic accident (RTA), assault, fall, sports-related injuries, and industrial trauma. Materials and Methods: A total of 50 patients records were taken from MLC books who sustained mandibular fracture presenting to the Department of Dentistry, K.R. Hospital from January 2016 to December 2016. A standardized maxillofacial trauma pro forma was used to record the data in relation to age, gender, etiology, and anatomical site. The mandibular fractures were classified based on the anatomical sites such as symphysis, parasymphysis, body, angle, ramus, condyle, coronoid, and dentoalveolar process. Patients were divided into the following age group of <10 years, 11–20 years, 21–30 years, 31–40 years, 41–50 years, and 50 years and above; data were obtained and analyzed using simple descriptive statistical analysis and Pearson's Chi-squared test. Results: A total of 50 patients with 70 fractures were analyzed for the study, in which 32 were male (64%) and 18 (36%) were female. The patients ranged from <10 years to 50 years. The highest prevalence of fracture occurred in the age group of 21–30 (33.3%) years followed by age group of 50 years and above (28.6%). Mandibular fractures are predominantly caused by RTA which consisted of (16/50, 32%). The second-most common was fall (13/50, 26%), followed by assault (10/50, 20%), sports (8/50, 16%), and industrial trauma (3/50, 6%). RTA was the main cause in the age group of 31–40 years. Fall was the second cause in the age group of 40–50 years and above. RTA remains the predominant cause of mandibular fracture in the age group of 31–40 years in this study. Conclusion: Among 70 fracture sites located in this study, sites which fracture were seen was parasymphysis 31.42%, followed by angle 20%, condyle 18.57%, symphysis and dentoalveolar 8.57%, body 7.14%, ramus 4.28%, and the least was coronoid 1.42%. The parasymphysis is the most common site of fracture in this study similar to the other previous studies. In cases with unilateral fractures, parasymphysis was the most common 33.33%, followed by the angle of 19.60%. The most common combination was parasymphysis and condyle.



How to cite this article:
Tejaswi S S, Subash T S. A clinical study of incidence, etiology, and pattern of mandibular fractures in K. R. Hospital, Mysore.Int J Prev Clin Dent Res 2018;5:50-52


How to cite this URL:
Tejaswi S S, Subash T S. A clinical study of incidence, etiology, and pattern of mandibular fractures in K. R. Hospital, Mysore. Int J Prev Clin Dent Res [serial online] 2018 [cited 2019 Sep 24 ];5:50-52
Available from: http://www.ijpcdr.org/text.asp?2018/5/4/50/259259


Full Text



 Introduction



The mandible is the only facial bone that has mobility and the second-most frequent fractured part of the facial skeleton because of the prominent location.[1],[2] Mandibular bone fracture constitute a substantial proportion of the facial trauma cases which consisted of 36%–59% of all maxillofacial fractures.[3],[4],[5] The main causes of mandible fractures in this study are road traffic accident (RTA), assault, fall, sports-related injuries, and industrial trauma. Many literature shows that RTA is the most common frequent etiologic factor in developing countries and assault is the common cause of fractures in developed countries. The management is quite difficult as it causes significance to gross disruption in anatomy, physiology of teeth, Temporo-Mandibular Joint (TMJ), and facial esthetics.

This retrospective study was performed to evaluate the incidence, etiology, and pattern of mandibular fracture among different age groups, in the Department of Dentistry, K. R. Hospital, from January 2016 to December 2016 period of 1 year.

 Materials and Methods



A total of 50 patient's records were taken from MLC books who sustained mandibular fracture presenting to the Department of Dentistry, K. R. Hospital from January 2016 to December 2016. A standardized maxillofacial trauma pro forma was used to record the data in relation to age, gender, etiology, and anatomical site. The mandibular fractures were classified based on the anatomical sites such as symphysis, parasymphysis, body, angle, ramus, condyle, coronoid, and dentoalveolar process. Patients were divided into the age group of <10 years, 11–20 years, 21–30 years, 31–40 years, 41–50 years, and 50 years and above; data were obtained and analyzed using simple descriptive statistical analysis and Pearson's Chi-squared test.

 Results



Age and gender distributions

A total of 50 patients with 70 fractures were analyzed for the study, in which 32 were male (64%) and 18 (36%) were female [Table 1]. The ratio of 5:3, the age of the patients ranged from <10 years to 50 years. The highest prevalence of the fracture occurred in the age group of 21–30 (33.3%) years followed by the group 50 years and above (28.6%).{Table 1}

Etiology

Mandibular fractures are predominantly caused by RTA which consisted of (16/50, 32%). The second-most common fracture was fall (13/50, 26%), followed by assault (10/50, 20%), sports (8/50, 16%), and industrial trauma (3/50, 6%). RTA was main cause in the age group of 31–40 years. Fall was the second cause in the age group of 50 years and above. RTA remains the predominant cause of mandibular fracture in the age group of 31–40 years in this study [Table 2].{Table 2}

Distribution of fracture site and patterns

The total number of mandibular fractures reported in this study was 70 out of 50 participants. Unilateral fractures accounted for 72.85% (51/70), whereas bilateral fractures accounted are 27.14% (19/70) [Table 3]. The most common site of mandible fracture reported in this study was parasymphysis (22/70, 31.42%), followed by angle (14/70, 20%), condyle (13/70, 18.75%), symphysis and dentoalveolar (6/70, 8.75%), body (5/70, 7.14%), ramus (3/70, 4.28%), and coronoid (1/70, 1.42%) least common fracture [Graph 1].{Table 3}[INLINE:1]

In unilateral side, parasymphysis fractures were the most common (17/51, 33.33%), followed by angle (10/51, 19.60%), and among the patients with bilateral fractures, fracture of parasymphysis was the most common (5/19, 26.31%), followed by the angle of the mandible (4/19, 21.05%), and least being ramus (1/19, 5.26%). Distribution of mandibular fracture in relation to site, is shown in [Table 3].

 Discussion



Mandibular bone fracture constitutes a substantial proportion of maxillofacial fractures accounting of 36%–59%. Data pertaining to this study show male dominance in the ratio of 5:3. The occurrence of this gender pattern correlates with the other studies.[6],[7] Male dominance probably due to higher social activity, drug abuse, vehicular driving, industrial works, and sport issues.[8],[9] The majority of the patients was 33.3% in the age group of 21–30 years. In particular, 21–30 years (33.3%) were the most commonly involved. The incidence of fracture increases from the age of 0 to 30 years and then progressively decreases from 45 years onward. Lesser occurrences of fracture probably due to indoor care, and in young persons, elastic nature of the bone makes them less prone to fracture.[10] The most frequent cause of mandible fracture in this study were RTA-32%, followed by fall 26%, then assault 20%, sports 16%, least being industrial trauma 6%, and others. This finding is consistent with the previous studies conducted by Vyas et al.[11] and Barde et al.[12] RTA is the major causes because of increased production of motor vehicles, easy availability and lack of stringent road traffic legislation, bad roads, increase vehicular movements, and decreased use of safety features such as helmets, seatbelts or airbags, and fast driving.

Among fractures sites located in this study, the most common sites were parasymphysis 31.42%, followed by angle 20%, condyle 18.57%, symphysis and dentoalveolar 8.57%, body 7.14%, ramus 4.28%, and least was coronoid 1.42%. The parasymphysis was the most common site of fracture in this study, similar to the other previous studies.[13],[14] Furthermore, due to horseshoe shaped structre of mandible, when forces are applied at parasymphysis region fractures tend to occur due to long canine root and convex structure.

In cases with unilateral fractures, parasymphysis was the most common 33.33%, followed by angle 19.60%. The most common combination was parasymphysis and condyle.

 Conclusion



A retrospective study of patient's documents collected from the MLC records at the Department of Dentistry K. R. Hospital, Mysore from January 2016 to December 2016 for 1 year period following were summarized; the incidence of mandibular fracture showed that the male-to-female ratio was 5:3 which showed a higher male dominance, the most affected age group were in young men in 20's, the most common cause of mandible fracture was RTA followed by fall, parasymphysis region is the most commonly affected followed by body and condyle least is coronoid, parasymphysis fracture associated with condyle was the most common probably due to contre-coup injuries.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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