Clinical experience evaluation and comparative analysis of the results of X-ray diagnostic methods in patients with traumatic fractures of the lower jaw

Abstract

Background. Computed tomography (СТ) examination is considered to be a routine method of examination of patients with a complicated maxillafacial trauma, but in some cases it remains as desirable, which is due to the level of technical equipment of the medical institution and the cost of the examination. Therefore, due to our opinion, the comparative evaluation of results of radiological examination (roentgenography of skull in 3 projections, CT) remains relevant for improving the quality of treatment of patients with mandibular fracture in accordance to modern requirements for the prevention of development of complications and comprehensive rehabilitation. Purpose – is to compare the diagnostical possibilities of the facial skull X-ray examination and CT for the identification of traumatic non-incendiary mandible fracture, in order to improve the quality of specialized medical care, prevention of complications and reduction of the term of rehabilitation. Materials and methods. The data, analyzed in this study, was taken from the medical histories of 72 patients with non-incendiary traumatic fracture of the lower jaw, who were hospitalized and treated in the head and neck surgery department of the Regional clinical hospital during the year 2023. All the patients were examined clinically, radiologically so as with labor parameters, according to the medical care guidelines. Roentgenography of the facial skull was carried out in 100% of cases with a mandatory description by a radiologist, 28% of patients were additionally examined using CT with 3D modeling. Results. Our own observations and evaluation of roentgenograms of the skull in different projections has reviewed again the presence of discrepancies between clinical manifestations and the radiological picture in some cases. These circumstances led to performing CT examination with 3D reconstruction. When comparing their results, the treatment tactics were changed, namely, the indications for surgical methods of repositioning and fixation of bone fragments (osteosynthesis) of the lower jaw with significant displacement, especially in the area of angle, branches and processes (outside the tooth row), were clarified. Conclusions. CT plays the important role in examination of patients with non-incendiary traumatic mandibular fracture due to its accuracy and informativeness. In 28% of own observations of these patients, the additional use of CT with 3D modeling made it possible to detail the nature of the violation of the integrity of the bone structure, make a background for the individualization of treatment, clarify the indications and necessity for surgical treatment, shorten the treatment time and rehabilitation period.