Do the benefits of rigid internal fixation of mandible fractures justify the added costs? Results from a randomized controlled trial.

Purpose: Owing to its putative advantages over conventional maxillomandibular fixation (MMF), open-reduction and rigid internal fixation (ORIF) is used frequently to treat mandible fractures, particularly in noncompliant patients. The resource-intensive nature of ORIF, the large variation in its use, and the lack of systematic studies substantiating ORIF attributed benefits compel a randomized controlled investigation comparing ORIF to MMF treatment. The objective of this study was to determine whether ORIF provides better clinical and functional outcomes than MMF in noncomplying type of patients with a similar range of mandible fracture severity.

Baseline characteristics and treatment preferences of oral surgery patients.

Purpose: Patient preferences for treatment choices may depend on patient characteristics. Using standard gamble (SG) and willingness to pay (WTP), this study compares preferences for treatment of mandibular fracture among patients in a low-income urban area.

Patients And Methods: Surveys of African-American and Hispanic adults receiving treatment at King/Drew Medical Center for either mandibular fracture (n = 98) or third molar removal (n = 105) were used to investigate differences in patient characteristics across treatment groups (third molar vs fracture) and treatment preference (wiring vs surgery).

Chronic posttraumatic stress disorder after facial injury: a 1-year prospective cohort study.

Background: This study examined the prevalence, severity, and predictors of persistent traumatic stress symptoms in socioeconomically disadvantaged adults after orofacial injury.

Methods: A 1-year prospective study of 336 socioeconomically disadvantaged adults treated for orofacial injury at a Level I trauma center was conducted. Univariate analyses were performed on early measures of injury characteristics, prior trauma exposure, coping resources, and psychosocial functioning to select potential predictors of 1-year posttraumatic stress disorder (PTSD) scores; independence of variable contribution was then evaluated in multiple regression analyses.

A qualitative study of hardiness and social support among underserved, inner-city minority adults recovering from oral surgery.

Using qualitative data, this study examines hardiness and social support among twenty-two African American and Hispanic subjects, at least 18 years of age, who received treatment for a jaw fracture and participated in an hour-long focus group to discuss the treatment they received at King/Drew Medical Center, an inner-city hospital in Los Angeles, California. Treatment was either a non-surgical wiring of the teeth closed for six to eight weeks or surgical placement of a metal bone plate in the lower jaw with a short period of jaw fixation following surgery. A mandibular fracture is one of the most common orofacial traumas for minority individuals, and the majority of these fractures among patients at urban trauma centers are a result of interpersonal violence.

Decision-making process for treatment of mandibular fractures among minority groups.

Objectives: While patients' preferences for medical care are widely studied, only a small number of studies have looked at the decision-making process for dental treatment of mandibular fracture. This study examines the decision-making process for treatment of mandibular fractures among minority groups. Study participants were asked to consider Maxillomandibular Fixation (MMF--a non-surgical approach of wiring the teeth for 4-8 weeks) or Rigid Internal Fixation (RIF--surgical placement of bone plate).

Using patient self-report data to evaluate orofacial surgical outcomes.

Objectives: This study analyzes results of 336 patients treated for mandible fractures at King/Drew Medical Center in South Central Los Angeles, California from August 1996 to December 2001. Subjects were enrolled in a prospective study to evaluate the association between patient's subjective evaluation and objective clinical evaluations on three surgical outcome measures following orofacial surgery.

Methods: Subjects were assessed at four time periods--hospital discharge, 10 days post-discharge, 1 month post-discharge and 6 months post-discharge.

A qualitative report of patient problems and postoperative instructions.

Purpose: While surgery related stress may interfere with the patient's ability to concentrate on instructions, language difficulty or low health literacy may also impede appropriate doctor/patient communication. The purpose of this study is to understand from a sample of minority patients the types of problems encountered during healing and the level of information regarding elements of postoperative instructions they recalled receiving at an inner-city safety net hospital. We initiated a qualitative study to understand the care sequence process and provision of informed consent and postoperative instruction.

Orofacial injury in underserved minority populations.

The translation of clinical and epidemiological research findings into cliniical practice in the management of orofacial injuries at an inner-city community promises a reduction in the incidence and severity of orofacial injuries. This article reports on the sociodemographic characteristics, economical impact, nature of injuries, and associated risk factors of mandible fractures sustained in the inner-city community treated at KDMC. An overwhelmingly high incidence of intentional/assaultive injuries were treated at KDMC that contribute to the escalating cost of medical care provided at the public county hospital.