Non-white people have a greater risk for maxillofacial trauma: findings from a 24-month retrospective study in Brazil

Conceição, Luciana Domingues; Lund, Rafael Guerra; Nascimento, Gustavo Giacomelli; Silva, Ricardo Henrique Alves da; Leite, Fábio Renato Manzolli

Abstract

AIM: To identify the predominant causes and types of maxillofacial trauma in Brazil. METHODS: Reports of corporal trauma (7,536) between 2009-2010 in the Brazilian Institute of Forensic Medicine were analyzed as to the presence of maxillofacial traumas. Victims' demographic and trauma characteristics were recorded. RESULTS: Data were submitted to chi-square test and to multivariate Poisson regression. 778 reports referred maxillofacial trauma. Most victims were men (50.8%) around 27.6 years. Main causes were physical aggression (88.1%) and traffic accidents (6.7%). The most affected extraoral area was the middle third (60.7%). Risk for trauma in the middle third was significantly higher among patients aged 61-75 (RR 1.32), and non-white patients (black-skinned RR 1.21; brown-skinned RR 1.18); while falls were associated with trauma in the lower third (RR1.79). CONCLUSIONS: Violence was the main cause of maxillofacial trauma. Prevention of interpersonal violence may be a key element to prevent maxillofacial trauma.

epidemiology; violence; maxillofacial injuries

References

¹ Gandhi S, Ranganathan LK, Solanki M, Mathew GC, Singh I, Bither S. Pattern of maxillofacial fractures at a tertiary hospital in northern India: a 4-year retrospective study of 718 patients. Dent Traumatol. 2011;27:257-62.
² Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofac Surg. 1990;48:926-32.
³ Kostakis G, Stathopoulos P, Dais P, Gkinis G, Igoumenakis D, Mezitis M, et al. An epidemiologic analysis of 1,142 maxillofacial fractures and concomitant injuries. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(Suppl 5):69-73.
⁴ Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:28-34.
⁵ Silva A, Faleiros HH, Shimizu WAL, Nogueira L de M, Nhãn LL, Silva, BMF da. et al. [The prevalence of falls and associated factors among the elderly according to ethnicity]. Cien Saude Colet. 2012;17:2181-90.
⁶ Soares Filho AM. Homicide victimization according to racial characteristics in Brazil. Rev Saude Publica. 2011;45:745-455.
⁷ Iida S, Kogo M, Sugiura T, Mima T, Matsuya T. Retrospective analysis of 1,502 patients with facial fractures. Int J Oral Maxillofac Surg. 2001;30:286-90.
⁸ Batista AM, Marques LS, Batista AE, Falci SG, Ramos-Jorge ML. Urban-rural differences in oral and maxillofacial trauma. Braz Oral Res. 2012;26:132-8.
⁹ Al-Khateeb T, Abdullah FM. Craniomaxillofacial injuries in the United Arab Emirates: a retrospective study. J Oral Maxillofac Surg. 2007;65:1094-101.
¹⁰ Van den Bergh B, Karagozoglu KH, Heymans MW, Forouzanfar T. Aetiology and incidence of maxillofacial trauma in Amsterdam: a retrospective analysis of 579 patients. J Craniomaxillofac Surg. 2012;40:e165-9.
¹¹ Munante-Cardenas JL, Olate S, Asprino L, de Albergaria Barbosa JR, de Moraes M, Moreira RW. Pattern and treatment of facial trauma in pediatric and adolescent patients. J Craniofac Surg. 2011;22:1251-5.
¹² Martini MZ, Takahashi A, de Oliveira Neto HG, de Carvalho Junior JP, Curcio R, Shinohara EH. Epidemiology of mandibular fractures treated in a Brazilian level I trauma public hospital in the city of São Paulo, Brazil. Braz Dent J. 2006;17:243-8.
¹³ Gulinelli JL, Saito CTMH, Garcia-Júnior IR, Panzarini SR, Poi WR, Sonoda CK, et al. Occurrence of tooth injuries in patients treated in hospital environment in the region of Aracatuba, Brazil during a 6-year period. Dent Traumatol. 2008;24:640-4.
¹⁴ lida S, Hassfeld S, Reuther T, Schweigert Hans-Gert, Haag C, Klein J, et al. Maxillofacial fractures resulting from falls. J Craniomaxillofac Surg. 2003;31:278-83.
¹⁵ Laski R, Ziccardi VB, Broder HL, Janal M. Facial trauma: a recurrent disease? The potential role of disease prevention. J Oral Maxillofac Surg. 2004;62:685-8.
¹⁶ Bacchieri G, Barros AJ. Traffic accidents in Brazil from 1998 to 2010: many changes and few effects. Rev Saude Publica. 2011;45:949-63.
¹⁷ Van Beek GJ, Merkx CA. Changes in the pattern of fractures of the maxillofacial skeleton. Int J Oral Maxillofac Surg. 1999;28:424-8.
¹⁸ Minayo MCS. Violence in adolescence: a public health problem. Cad Saude Publica. 1990;6:278-92.
¹⁹ De Matos FP, Arnez MF, Sverzut CE, Trivellato AE. A retrospective study of mandibular fracture in a 40-month period. Int J Oral Maxillofac Surg. 2010;39:10-5.
²⁰ Lee JH, Cho BK, Park WJ. A 4-year retrospective study of facial fractures on Jeju, Korea. J Craniomaxillofac Surg. 2010;38:192-6.
²¹ Cheema SA, Amin F. Incidence and causes of maxillofacial skeletal injuries at the Mayo Hospital in Lahore, Pakistan. Br J Oral Maxillofac Surg. 2006;44:232-4.
²² Bakardjiev A, Pechalova P. Maxillofacial fractures in Southern Bulgaria - a retrospective study of 1,706 cases. J Craniomaxillofac Surg. 2007;35:147-50.
²³ Gerbino G, Roccia F, De Gioanni PP, Berrone S. Maxillofacial trauma in the elderly. J Oral Maxillofac Surg. 1999;57:777-82; discussion 82-3.
²⁴ Falcone PA, Haedicke GJ, Brooks G, Sullivan PK. Maxillofacial fractures in the elderly: a comparative study. Plast Reconstr Surg. 1990;86:443-8.
²⁵ Kieser J, Stephenson S, Liston PN, Tong DC, Langley JD. Serious facial fractures in New Zealand from 1979 to 1998. Int J Oral Maxillofac Surg. 2002;31:206-9.
²⁶ Erol B, Tanrikulu R, Gorgun B. Maxillofacial fractures. Analysis of demographic distribution and treatment in 2,901 patients (25-year experience). J Craniomaxillofac Surg. 2004;32:308-13.
²⁷ Motamedi MH, Sagafinia M, Famouri-Hosseinizadeh M. Oral and maxillofacial injuries in civilians during training at military garrisons: prevalence and causes. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114:49-51.
²⁸ Castro JC, Poi WR, Manfrin TM, Zina LG. Analysis of the crown fractures and crown-root fractures due to dental trauma assisted by the Integrated Clinic from 1992 to 2002. Dent Traumatol. 2005;21:121-6.
²⁹ Santos SE, Marchiori EC, Soares AJ, Asprino L, de Souza Filho FJ, de Moraes M, et al. A 9-year retrospective study of dental trauma in Piracicaba and neighboring regions in the State of São Paulo, Brazil. J Oral Maxillofac Surg. 2010;68:1826-32.
³⁰ Caldas IM, Magalhães T, Afonso A, Matos E. The consequences of orofacial trauma resulting from violence: a study in Porto Dent Traumatol. 2010;26:484-9.

Publication Dates

Publication in this collection
31 Jan 2014
Date of issue
Dec 2013

History

Received
30 Aug 2013
Accepted
28 Nov 2013

This work is licensed under a Creative Commons Attribution 4.0 International License.

[1] ¹ Gandhi S, Ranganathan LK, Solanki M, Mathew GC, Singh I, Bither S. Pattern of maxillofacial fractures at a tertiary hospital in northern India: a 4-year retrospective study of 718 patients. Dent Traumatol. 2011;27:257-62.

[2] ² Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofac Surg. 1990;48:926-32.

[3] ³ Kostakis G, Stathopoulos P, Dais P, Gkinis G, Igoumenakis D, Mezitis M, et al. An epidemiologic analysis of 1,142 maxillofacial fractures and concomitant injuries. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(Suppl 5):69-73.

[4] ⁴ Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil: a 5-year prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:28-34.

[5] ⁵ Silva A, Faleiros HH, Shimizu WAL, Nogueira L de M, Nhãn LL, Silva, BMF da. et al. [The prevalence of falls and associated factors among the elderly according to ethnicity]. Cien Saude Colet. 2012;17:2181-90.

[6] ⁶ Soares Filho AM. Homicide victimization according to racial characteristics in Brazil. Rev Saude Publica. 2011;45:745-455.

[7] ⁷ Iida S, Kogo M, Sugiura T, Mima T, Matsuya T. Retrospective analysis of 1,502 patients with facial fractures. Int J Oral Maxillofac Surg. 2001;30:286-90.

[8] ⁸ Batista AM, Marques LS, Batista AE, Falci SG, Ramos-Jorge ML. Urban-rural differences in oral and maxillofacial trauma. Braz Oral Res. 2012;26:132-8.

[9] ⁹ Al-Khateeb T, Abdullah FM. Craniomaxillofacial injuries in the United Arab Emirates: a retrospective study. J Oral Maxillofac Surg. 2007;65:1094-101.

[10] ¹⁰ Van den Bergh B, Karagozoglu KH, Heymans MW, Forouzanfar T. Aetiology and incidence of maxillofacial trauma in Amsterdam: a retrospective analysis of 579 patients. J Craniomaxillofac Surg. 2012;40:e165-9.

[11] ¹¹ Munante-Cardenas JL, Olate S, Asprino L, de Albergaria Barbosa JR, de Moraes M, Moreira RW. Pattern and treatment of facial trauma in pediatric and adolescent patients. J Craniofac Surg. 2011;22:1251-5.

[12] ¹² Martini MZ, Takahashi A, de Oliveira Neto HG, de Carvalho Junior JP, Curcio R, Shinohara EH. Epidemiology of mandibular fractures treated in a Brazilian level I trauma public hospital in the city of São Paulo, Brazil. Braz Dent J. 2006;17:243-8.

[13] ¹³ Gulinelli JL, Saito CTMH, Garcia-Júnior IR, Panzarini SR, Poi WR, Sonoda CK, et al. Occurrence of tooth injuries in patients treated in hospital environment in the region of Aracatuba, Brazil during a 6-year period. Dent Traumatol. 2008;24:640-4.

[14] ¹⁴ lida S, Hassfeld S, Reuther T, Schweigert Hans-Gert, Haag C, Klein J, et al. Maxillofacial fractures resulting from falls. J Craniomaxillofac Surg. 2003;31:278-83.

[15] ¹⁵ Laski R, Ziccardi VB, Broder HL, Janal M. Facial trauma: a recurrent disease? The potential role of disease prevention. J Oral Maxillofac Surg. 2004;62:685-8.

[16] ¹⁶ Bacchieri G, Barros AJ. Traffic accidents in Brazil from 1998 to 2010: many changes and few effects. Rev Saude Publica. 2011;45:949-63.

[17] ¹⁷ Van Beek GJ, Merkx CA. Changes in the pattern of fractures of the maxillofacial skeleton. Int J Oral Maxillofac Surg. 1999;28:424-8.

[18] ¹⁸ Minayo MCS. Violence in adolescence: a public health problem. Cad Saude Publica. 1990;6:278-92.

[19] ¹⁹ De Matos FP, Arnez MF, Sverzut CE, Trivellato AE. A retrospective study of mandibular fracture in a 40-month period. Int J Oral Maxillofac Surg. 2010;39:10-5.

[20] ²⁰ Lee JH, Cho BK, Park WJ. A 4-year retrospective study of facial fractures on Jeju, Korea. J Craniomaxillofac Surg. 2010;38:192-6.

[21] ²¹ Cheema SA, Amin F. Incidence and causes of maxillofacial skeletal injuries at the Mayo Hospital in Lahore, Pakistan. Br J Oral Maxillofac Surg. 2006;44:232-4.

[22] ²² Bakardjiev A, Pechalova P. Maxillofacial fractures in Southern Bulgaria - a retrospective study of 1,706 cases. J Craniomaxillofac Surg. 2007;35:147-50.

[23] ²³ Gerbino G, Roccia F, De Gioanni PP, Berrone S. Maxillofacial trauma in the elderly. J Oral Maxillofac Surg. 1999;57:777-82; discussion 82-3.

[24] ²⁴ Falcone PA, Haedicke GJ, Brooks G, Sullivan PK. Maxillofacial fractures in the elderly: a comparative study. Plast Reconstr Surg. 1990;86:443-8.

[25] ²⁵ Kieser J, Stephenson S, Liston PN, Tong DC, Langley JD. Serious facial fractures in New Zealand from 1979 to 1998. Int J Oral Maxillofac Surg. 2002;31:206-9.

[26] ²⁶ Erol B, Tanrikulu R, Gorgun B. Maxillofacial fractures. Analysis of demographic distribution and treatment in 2,901 patients (25-year experience). J Craniomaxillofac Surg. 2004;32:308-13.

[27] ²⁷ Motamedi MH, Sagafinia M, Famouri-Hosseinizadeh M. Oral and maxillofacial injuries in civilians during training at military garrisons: prevalence and causes. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114:49-51.

[28] ²⁸ Castro JC, Poi WR, Manfrin TM, Zina LG. Analysis of the crown fractures and crown-root fractures due to dental trauma assisted by the Integrated Clinic from 1992 to 2002. Dent Traumatol. 2005;21:121-6.

[29] ²⁹ Santos SE, Marchiori EC, Soares AJ, Asprino L, de Souza Filho FJ, de Moraes M, et al. A 9-year retrospective study of dental trauma in Piracicaba and neighboring regions in the State of São Paulo, Brazil. J Oral Maxillofac Surg. 2010;68:1826-32.

[30] ³⁰ Caldas IM, Magalhães T, Afonso A, Matos E. The consequences of orofacial trauma resulting from violence: a study in Porto Dent Traumatol. 2010;26:484-9.