Analysis of the blood supply to the post-fracture edentulous mandible: study by colour Doppler sonography.
OBJECTIVE
This study assessed the arterial blood supply to the mandible of edentulous patients treated for mandibular fractures using colour Doppler ultrasound.


METHODS
The blood supply of edentulous patients surgically treated for mandibular fractures (group A) and edentulous fracture-free individuals (group B) was assessed. Only the fractured sides were evaluated in the first group (N = 17), whereas each side was evaluated in the second group (N = 20). The arterial flow of six sites was assessed. The systolic-peak maximum velocity (SPV), final diastolic velocity (FDV), resistive index (RI), pulsatility index (PI), acceleration and flow direction of each artery were obtained. Additionally, the presence of local vascular obstructive factors was evaluated. The differences between groups were analysed using the Kruskal-Wallis test, which was complemented by the Mann-Whitney test, for correlations between the degree of alveolar atrophy and the study factors (p < 0.050).


RESULTS
There was a significant decrease in the flow of certain arteries, especially the submental (SPV, p = 0.007, PI, p = 0.022, and acceleration, p = 0.015), in the fracture group. The facial artery in both groups showed lower values related to local obstructive factors (SPV, p = 0.001, FDV, p = 0.040, and PI, p = 0.030). The submental artery flow was higher (SPV, p = 0.006, and FDV, p = 0.009) in non-atrophic individuals.


CONCLUSIONS
There was a decreased flow mainly in the submental artery, but there were no cases of major vascular injury in edentulous patients treated for mandibular fractures.
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo-USP, Brazil, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, 02036-021, São Paulo, SP, Brazil.
Júlio Cezar M A
JC
Mancini
Department of Diagnostic Imaging, University Hospital, University of São Paulo, São Paulo, Brazil.
Márcio Ricardo Taveira
MR
Garcia
Department of Diagnostic Imaging, University Hospital, University of São Paulo, São Paulo, Brazil.
Ilka Regina Souza
IR
de Oliveira
Department of Oral and Maxillofacial Surgery, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
Ronaldo Rodrigues
RR
de Freitas
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo-USP, Brazil, Av. Prof. Lineu Prestes, 2227-Cidade Universitária, 02036-021, São Paulo, SP, Brazil. jgcluz@usp.br.
João Gualberto C
JG
Luz
D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008334:Mandible / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D008337:Mandibular Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000000981:diagnostic imaging* / Q000601:surgery*; D011673:Pulsatile Flow / Q000502:physiology; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D018615:Ultrasonography, Doppler, Color; D014655:Vascular Resistance / Q000502:physiology
Colour Doppler ultrasonography; Edentulous; Fracture healing; Jaw; Mandibular fractures
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