Advantages of intraoral and transconjunctival approaches for posterior displacement of a fractured zygomaticomaxillary complex.
BACKGROUND
Fracture of the zygomaticomaxillary complex (ZMC) is one of the most common facial injuries. A previous study has performed 3D analyses of the parallel and rotational displacements that occur in a fractured ZMC. However, few studies have investigated adequate fixation methods according to these displacements. Here, we assessed whether specific approaches and fixation methods for displacement of ZMC fractures produce esthetic results.


METHODS
Hospital records and pre- and post-surgical computed tomographic scans of patients treated for ZMC fractures at the Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, between January 2010 and December 2015, were selected. Data were analyzed according to the direction of displacement and post-reduction prognosis using a 3D software.


RESULTS
With ZMC fractures, displacement in the posterior direction occurred most frequently, while displacement in the superior-inferior direction was rare. A reduction using a transconjunctival approach and an intraoral approach was statistically better than that using an intraoral approach, Gillies approach, and lateral canthotomy approach for a posterior displacement (P< 0.05).


CONCLUSIONS
When posterior displacement of a fractured ZMC occurs, use of an intraoral approach and transconjunctival approach simultaneously is recommended for reducing and fixing the displaced fragment accurately.
Department of Oral and Maxillofacial Surgery, College of Dentistry, and Dental Hospital, Wonkwang University, 460, Iksandae-ro, Iksan, Jeollabuk-do South Korea.
Ji Yong
JY
Yoo
Department of Oral and Maxillofacial Surgery, College of Dentistry, and Dental Hospital, Wonkwang University, 460, Iksandae-ro, Iksan, Jeollabuk-do South Korea.
Jang Won
JW
Lee
Department of Oral and Maxillofacial Surgery, College of Dentistry, and Dental Hospital, Wonkwang University, 460, Iksandae-ro, Iksan, Jeollabuk-do South Korea.
Seung Jae
SJ
Paek
Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, South Korea.
Won Jong
WJ
Park
Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, South Korea.
Eun Joo
EJ
Choi
Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, South Korea.
Kyung-Hwan
KH
Kwon
Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang Dental Research Institute, Wonkwang University, Iksan, South Korea.
Moon-Gi
MG
Choi
Displacement direction; Surgical approach; Zygomaticomaxillary complex (ZMC) fracture