Background/Aims: Approximately 20% of patients with maxillofacial trauma are women, but few articles have analysed this. The aim of this multicentric, prospective, epidemiological study was to analyse the characteristics of maxillofacial fractures in the female population managed in 14 maxillofacial surgery departments on five continents over a 1‐year period.Methods: The following data were collected: age (0–18, 19–64, or ≥65 years), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment, and length of hospitalization.Results: Between 30 September 2019 and 4 October 2020, 562 of 2387 patients hospitalized with maxillofacial trauma were females (24%; M: F ratio, 3.2:1) aged between 1 and 96 years (median age, 37 years). Most fractures occurred in patients aged 20–39 years. The main causes were falls (43% [median age, 60.5 years]), which were more common in Australian, European and American units (p < .001). They were followed by road traffic accidents (35% [median age, 29.5 years]). Assaults (15% [median age, 31.5 years]) were statistically associated with alcohol and/or drug abuse (p < .001). Of all patients, 39% underwent open reduction and internal fixation, 36% did not receive surgical treatment, and 25% underwent closed reduction.Conclusion: Falls were the main cause of maxillofacial injury in the female population in countries with ageing populations, while road traffic accidents were the main cause in African and some Asian centres, especially in patients ≤65 years. Assaults remain a significant cause of trauma, primarily in patients aged 19–64 years, and they are related to alcohol use.

Background: Mandibular condyle fractures in pediatric patients can lead to crippling sequelae such as ankylosis, pain and facial deformity if not managed properly. However, there is no consensus on the best approach for treating these fractures in children. Objective: This study aimed to describe the management of mandibular condyle fractures in growing patients across 14 maxillofacial departments worldwide. Methods: A retrospective multicenter study was conducted on children and adolescents aged 0 to 16 who had at least one mandibular condyle fracture. This study included patients who underwent expectant, closed, or open management and were treated over an 11-year period. Results: 180 patients had at least one mandibular condyle fracture, and 37 had a second condylar fracture. One hundred sixteen patients (65%) were males, and 64 (35%) were females (ratio 1.8:1). An expectant strategy was chosen in 51 (28%) patients, a closed treatment—stand-alone maxillomandibular fixation (MMF)—in 47 (26%), and open reduction and internal fixation (ORIF) was performed in 82 (46%) patients. The management varied significantly between the different departments (p < 0.0001). Significant differences were also identified between the fracture type (non-displaced, displaced or comminuted) and the management of the 180 patients with a single condylar fracture. Out of 50 non-displaced fractures, only 3 (6%) had ORIF, 25 (50%) had expectant management, and 22 (44%) had MMF. Out of 129 displaced fractures, 79 (62%) had ORIF, 25 (19%) had a soft diet, and 25 (19%) had MMF. Conclusions: Expectative management, MMF, and ORIF were all effective in treating pediatric mandibular condyle fractures, with a low incidence of complications and asymmetry.

Rodrigo dos Santos Pereira, DDS, MSc, PhD/Fernanda Brasil Jorge Daura Boos, DDS, MSc, PhD/Luis Fernado Gorla, DDS/Idelmo Rangel Garcia Jr, DDS, MSc, PhD/Roberta Okamoto, DDS, MSc, PhD/Eduardo Hochuli-Vieira, DDS, MSc, PhD: The aim of this study was to compare the bone resorption rate and histometry of ChronOS, a beta-tricalcium phosphate (β-TCP), mixed with autogenous bone grafts (1:1) with that of autogenous bone grafts alone in maxillary sinus elevation surgery. A total of 12 maxillary sinuses were grafted with an autogenous bone graft (control group) and 9 with ChronOS mixed with an autogenous bone graft (test group). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T₁), and 6 months later another CBCT scan was performed to evaluate the final graft volume (T₂) and determine the graft resorption rate. The resorption outcomes were 45.7% ± 18.6% in the control group and 38.3% ± 16.6% in the test group (P = .17); the bone formation rate was 38.6% ± 10.5% in the control group and 25.4% ± 6.4% in the test group (P = .001). ChronOS mixed with autogenous bone graft demonstrated a resorption rate similar to that of the autogenous bone graft but with a difference in bone formation after 6 months.

Rodrigo dos Santos Pereira, DDS, MSc, PhD/Fernanda Brasil Jorge Daura Boos, DDS, MSc, PhD/Luis Fernado Gorla, DDS/Idelmo Rangel Garcia Jr, DDS, MSc, PhD/Roberta Okamoto, DDS, MSc, PhD/Eduardo Hochuli-Vieira, DDS, MSc, PhD: The purpose of this study was to evaluate a composite graft of ChronOS, a betatricalcium phosphate (β-TCP), mixed 1:1 with an autogenous bone graft in human maxillary sinus augmentation. A total of 12 maxillary sinuses were grafted with an autogenous bone graft (control group), and 9 maxillary sinuses were grafted with ChronOS mixed 1:1 with an autogenous bone graft (test group). After 6 months, biopsy samples were obtained concurrent to the placement of dental implants and were subjected to histomorphometric and immunohistochemical analyses for Runt-related transcription factor 2 (RUNX2), vascular endothelial growth factor (VEGF), tartrate-resistant acid phosphatase, and osteocalcin. Histologic analysis of samples obtained from the test group revealed the presence of immature bone, while samples from the control group indicated lamellar bone formation. However, both types of bone grafts were well vascularized. The new bone formation averaged 25.4% ? 6.4% in the test group and 38.6% ? 10.5% in the control group (P = .001). Immunostaining of samples in the test group showed high cellular turnover. The outcomes of this study demonstrate a delay in bone formation but intense cellular differentiation after 6 months of bone graft healing in the test group. The amount of immature bone and the immunostaining for RUNX2 and VEGF provide evidence of an osteogenic pathway that can improve the bone formation rate.