Volume 12, Issue 1 (2023)                   WJPS 2023, 12(1): 3-11 | Back to browse issues page


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1- Department of Oral & Maxillofacial Surgery, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Department of Oral & Maxillofacial Surgery, Traumatology and Prosthesis, University of São Paulo, São Paulo, Brazil.
3- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
4- Department of Plastic Surgery, Iran University of Medical Sciences, Tehran, Iran.
5- Department of Medical education, Tehran university of Medical Sciences, Tehran, Iran.
Abstract:   (1478 Views)
Background: Maxillofacial fractures are a common type of injury that can result in significant morbidity and mortality. We aimed to systematically review the literature on the prevalence and causes of maxillofacial fractures in Iran to estimate the overall prevalence of maxillofacial fractures and the most common causes.
Methods: A systematic search of PubMed, Cochrane Library, Web of Science (WS) and Google Scholar (GS) electronic databases was conducted to identify relevant articles published up to January 2023. Studies reporting the prevalence and causes of maxillofacial fractures in Iran were included in the analysis. MOOSE guidelines were adopted for the current systematic review. No data or language restriction were applied. Risk of bias across the articles was assessed.
Results: A total of 32 studies comprising 35,720 patients were included in the analysis. The most common cause of maxillofacial fractures was road traffic accidents (RTAs), accounting for 68.97% of all cases, followed by falls (12.62%) and interpersonal violence (9.03%). The prevalence of maxillofacial fractures was higher in males (81.04%) and in the age group of 21-30 years (43.23%). Risk of bias across studies was considered low.
Conclusion: Maxillofacial fractures are a significant public health problem in Iran, with a high prevalence and RTAs being the leading cause. These results highlight the need for increased efforts to prevent maxillofacial fractures in Iran, especially through measures to reduce the incidence of RTAs.
 
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Type of Study: Review Article | Subject: Special
ePublished: 2023/02/25

References
1. Romeo I, Sobrero F, Roccia F, Dolan S, Laverick S, Carlaw K, et al. A multicentric, prospective study on oral and maxillofacial trauma in the female population around the world. Dent Traumatol 2022;38:196-205. [DOI:10.1111/edt.12750]
2. Roccia F, Iocca O, Sobrero F, Rae E, Laverick S, Carlaw K, et al. World Oral and Maxillofacial Trauma (WORMAT) project: A multicenter prospective analysis of epidemiology and patterns of maxillofacial trauma around the world. J Stomatol Oral Maxillofac Surg 2022;123:e849-57. [DOI:10.1016/j.jormas.2022.05.004]
3. Salzano G, Orabona GDA, Audino G, Vaira LA, Trevisiol L, D'Agostino A, et al. Have There Been any Changes in the Epidemiology and Etiology of Maxillofacial Trauma During the COVID-19 Pandemic? An Italian Multicenter Study. J Craniofac Surg 2021;32:1445-7. [DOI:10.1097/SCS.0000000000007253]
4. Gandjalikhan-Nassab S, Samieirad S, Vakil-Zadeh M, Habib-Aghahi R, Alsadat-Hashemipour M. Depression and anxiety disorders in a sample of facial trauma: A study from Iran. Med Oral Patol Oral Cir Bucal 2016;21:e477-82. [DOI:10.4317/medoral.21068]
5. Segura-Palleres I, Sobrero F, Roccia F, de Oliveira Gorla LF, Pereira-Filho VA, Gallafassi D, et al. Characteristics and age-related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study. Dent Traumatol 2022;38:213-22. [DOI:10.1111/edt.12735]
6. Chukwulebe S, Hogrefe C. The Diagnosis and Management of Facial Bone Fractures. Emerg Med Clin North Am 2019;37:137-51. [DOI:10.1016/j.emc.2018.09.012]
7. Chrcanovic BR. Factors influencing the incidence of maxillofacial fractures. Oral Maxillofac Surg 2012;16:3-17. [DOI:10.1007/s10006-011-0280-y]
8. Alharbi FA, Makrami AM, Ali FM, Maghdi AA. Patterns and Etiology of Maxillofacial Fractures: A 5-year Retrospective Study. J Contemp Dent Pr 2020;21:445-52. [DOI:10.5005/jp-journals-10024-2808]
9. Khan TU, Rahat S, Khan ZA, Shahid L, Banouri SS, Muhammad N. Etiology and pattern of maxillofacial trauma. PLoS One 2022;17:e0275515. [DOI:10.1371/journal.pone.0275515]
10. Samieirad S, Tohidi E, Shahidi-Payam A, Hashemipour MA, Abedini A. Retrospective study maxillofacial fractures epidemiology and treatment plans in Southeast of Iran. Med Oral Patol Oral Cir Bucal 2015;20:e729-36. [DOI:10.4317/medoral.20652]
11. Ansari MH. Maxillofacial fractures in Hamedan province, Iran: A retrospective study (1987-2001). J Craniomaxillofacial Surg 2004;32:28-34. [DOI:10.1016/j.jcms.2003.07.010]
12. Farzan R, Farzan A, Farzan A, Karimpour M, Tolouie M. A 6-Year Epidemiological Study of Mandibular Fractures in Traumatic Patients in North of Iran: Review of 463 Patients. World J Plast Surg 2021;10:71-7. [DOI:10.29252/wjps.10.1.71]
13. Hashemi HM, Beshkar M. The prevalence of maxillofacial fractures due to domestic violence - a retrospective study in a hospital in Tehran, Iran. Dent Traumatol 2011;27:385-8. [DOI:10.1111/j.1600-9657.2011.01016.x]
14. Kadkhodaie MH. Three-year review of facial fractures at a teaching hospital in northern Iran. Br J Oral Maxillofac Surg 2006;44:229-31. [DOI:10.1016/j.bjoms.2005.06.016]
15. Mesgarzadeh AH, Shahamfar M, Azar SF, Shahamfar J. Analysis of the pattern of maxillofacial fractures in north western of Iran: A retrospective study. Jounal Emergences, Shock Trauma 2011;4:48-52. [DOI:10.4103/0974-2700.76837]
16. Mohajerani SH, Asghari S. Pattern of mid-facial fractures in Tehran, Iran. Dent Traumatol 2011;27:131-4. [DOI:10.1111/j.1600-9657.2011.00979.x]
17. Mosaddad SA, Gheisari R, Erfani M. Oral and maxillofacial trauma in motorcyclists in an Iranian subpopulation. Dent Traumatol 2018;34:347-52. [DOI:10.1111/edt.12428]
18. Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928. [DOI:10.1136/bmj.d5928]
19. Egger M, Smith GD, Altman DG. Systematic Reviews in Health Care: Meta-Analysis in Context: Second Edition. Systematic Reviews in Health Care: Meta-Analysis in Context: Second Edition. 2008. 1-487 p. [DOI:10.1002/9781119099369.ch1]
20. Ackley BJ, Ladwig GB, Swan BA, Tucker SJ. Evidence-Based Nursing Care Guidelines. Mosby, editor. 2007.
21. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000;283:2008-12. [DOI:10.1001/jama.283.15.2008]
22. Ebrahimi A, Behzadi BA, Motamedi MHK, Rasouli HR. Epidemiologic patterns of maxillofacial fractures: A 5-year study in one of the referral hospitals of Iran. Trauma Mon 2021;26:258-64.
23. Haghighat A, Pourarz S, Zarghami A. Epidemiologic Evaluation of Maxillofacial Trauma in Alzahra Hospital, Isfahan. Int J Epidemiol Res 2020;7:152-6. [DOI:10.34172/ijer.2020.27]
24. Ghorbani F, Khalili M, Ahmadi H. The evaluation of alveolar fractures of trauma patients in Iran. BMC Oral Health 2021;21:499. [DOI:10.1186/s12903-021-01863-y]
25. Sarkarat F, Motamedi MHK, Aghdam HM, Rastegarmoghadamshalduzi H. Evaluation of Oral and Maxillofacial Trauma in Tehran from 2008 to 2016. Trauma Mon 2019;24:e67802.
26. Arabion H, Tabrizi R, Aliabadi E, Gholami M, Zarei K. A retrospective analysis of maxillofacial trauma in shiraz, iran: a 6-year- study of 768 patients (2004-2010). J Dent (Shiraz, Iran) 2014;15:15-21.
27. Latifi H. Prevalence of different kinds of maxillofacial fractures and their associated factors are surveyed in patients. Glob J Health Sci 2014;6:66-73. [DOI:10.5539/gjhs.v6n7p66]
28. Momeni H, Shahnaseri S, Hamzeheil Z. Distribution assessment of maxillofacial fractures in trauma admitted patients in Yazd hospitals: An epidemiologic study. Dent Res J (Isfahan) 2011;8:80-3.
29. Vahedi HS, Vahidi E, Basirian R, Saeedi M. Assessment of Maxillofacial Trauma in the Emergency Department. Trauma Mon 2017;22:e58204.
30. Khojastepour L, Moannaei M, Eftekharian HR, Khaghaninejad MS, Mahjoori-Ghasrodashti M, Tavanafar S. Prevalence and severity of orbital blowout fractures. Br J Oral Maxillofac Surg 2020;58:e93-7. [DOI:10.1016/j.bjoms.2020.07.001]
31. Motamedi MHK. An assessment of maxillofacial fractures: A 5-year study of 237 patients. J Oral Maxillofac Surg 2003;61:61-4. [DOI:10.1053/joms.2003.50049]
32. Motamedi MHK. Primary Management of Maxillofacial Hard and Soft Tissue Gunshot and Shrapnel Injuries. J Oral Maxillofac Surg 2003;61:1390-8. [DOI:10.1016/j.joms.2003.07.001]
33. Motamedi MHK, Dadgar E, Ebrahimi A, Shirani G, Haghighat A, Jamalpour MR. Pattern of maxillofacial fractures: A 5-year analysis of 8,818 patients. J Trauma Acute Care Surg 2014;77:630-4. [DOI:10.1097/TA.0000000000000369]
34. Ramezanian M, Mahmoud-Hashemi H, Vaezi T, Beshkar M, Hasheminasab M. The pattern of maxillofacial fractures: a study of 302 patients and a discussion of fracture classification. J Craniomaxillofacial Res 2015;2:95-102.
35. Rezaei M, Jamshidi S, Jalilian T, Falahi N. Epidemiology of maxillofacial trauma in a university hospital of Kermanshah, Iran. J Oral Maxillofac Surgery Med Pathol 2017;29:110-5. [DOI:10.1016/j.ajoms.2016.09.008]
36. Yadollahi M, Sahmeddini S. An overview of the prevalence and pattern of maxillofacial trauma in the south of Iran. J Emerg Pract Trauma 2021;7:118-22. [DOI:10.34172/jept.2021.13]
37. Zandi M, Khayati A, Lamei A, Zarei H. Maxillofacial injuries in western Iran: A prospective study. Oral Maxillofac Surg 2011;15:201-9. [DOI:10.1007/s10006-011-0277-6]
38. Zargar M, Khaji A, Karbakhsh M, Zarei MR. Epidemiology study of facial injuries during a 13 month of trauma registry in Tehran. Indian J Med Sci 2004;58:109-14.
39. Mehravaran R, Akbarian G, Nezhad CM, Gheisari R, Ziaei M, Zadeh FG. Evaluation of the relationship between the pattern of midfacial fractures and amaurosis in patients with facial trauma. J Oral Maxillofac Surg 2013;71:1059-62. [DOI:10.1016/j.joms.2013.01.007]
40. Ghaffari-Fam S, Sarbazi E, Daemi A, Sarbazi M, Riyazi L, Sadeghi-Bazargani H, et al. Epidemiological and Clinical Characteristics of Fall Injuries in East Azerbaijan, Iran; A Cross-Sectional Study. Bull Emerg Trauma 2015;3:104-10.
41. Mohammadi S, Mohebbi S. Occurrence of mandibulofacial injuries presenting to the Otorhinolaryngology and Head & Neck Surgery Department. J Craniofac Surg 2007;18:833-7. [DOI:10.1097/scs.0b013e3180684589]
42. Samieirad S, Aboutorabzade MR, Tohidi E, Shaban B, Khalife H, Hashemipour MA, et al. Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study. Med Oral Patol Oral Cir Bucal 2017;22:e616-24. [DOI:10.4317/medoral.21809]
43. Sarafraz Z, Mirshamsi MH, Musavi SA, Azaraein MH. Assessing the Ignored Associated Injuries of the Ear, Nose and Throat in Patients with Multiple Trauma in Shahid Rahnamun Hospital of Yazd in 2012 and 2013. Electron Physician 2015;7:1121-5.
44. Akhlaghi F, Mafi N, Bastami F. Prevalence of Maxillofacial Fractures and Related Factors: A Five-Year Retrospective Study. Trauma Mon 2019;24:1-4. [DOI:10.5812/traumamon.83974]
45. Dibaie A, Raissian S, Ghafarzadeh S. Evaluation of maxillofacial traumatic injuries of forensic medical center of ahwaz, Iran, in 2005. Pakistan J Med Sci 2009;25:79-82.
46. Lima Júnior SM, Santos SE, Kluppel LE, Asprino L, Moreira RWF, de Moraes M. A comparison of motorcycle and bicycle accidents in oral and maxillofacial trauma. J Oral Maxillofac Surg 2012;70:577-83. [DOI:10.1016/j.joms.2011.03.035]
47. Chuang KT, Hsieh F, Liao HT. The Correlation of Age and Patterns of Maxillofacial Bone Fractures and Severity of Associated Injuries Caused by Motorcycle Accidents. Ann Plast Surg 2019;83:e28-34. [DOI:10.1097/SAP.0000000000001943]
48. Arpalahti A, Haapanen A, Puolakkainen T, Abio A, Thorén H, Snäll J. Assault-related facial fractures: does the injury mechanism matter? Int J Oral Maxillofac Surg 2022;51:91-7. [DOI:10.1016/j.ijom.2021.06.001]
49. Wusiman P, Maimaitituerxun B, Guli, Saimaiti A, Moming A. Epidemiology and Pattern of Oral and Maxillofacial Trauma. J Craniofac Surg 2020;31:e517-20. [DOI:10.1097/SCS.0000000000006719]
50. Aytaç I, Yazici A, Tunç O. Maxillofacial Trauma in Geriatric Population. J Craniofac Surg 2020;31:e695-8. [DOI:10.1097/SCS.0000000000006612]
51. Lee DH, Han SS, Kim DH, Kim EC, Lee EH, Park JO, et al. Clinical Characteristics Associated with Physical Violence in the Elderly: A Retrospective Multicenter Analysis. Iran J Public Health 2022;51:79-87. [DOI:10.18502/ijph.v51i1.8296]
52. Godfrey A, Lord S, Mathers JC, Burn DJ, Rochester L. The association between retirement and age on physical activity in older adults. Age Ageing 2014;43:386-93. [DOI:10.1093/ageing/aft168]
53. Grillo R, Slusarenko da Silva Y, Tavares MG, Borba AM, Naclério-Homem M da G. Which sports have a higher risk of maxillofacial injuries? J Stomatol Oral Maxillofac Surg 2022;S2468-7855:00354-8.
54. Yang SC, Johnson DG, Keefe SH, Bast BT. Aquatic Activity-Related Craniofacial Injuries Presenting to United States Emergency Departments, 2010 to 2019. J Oral Maxillofac Surg 2021;79:2538.e1-2538.e6. [DOI:10.1016/j.joms.2021.07.018]
55. Povolotskiy R, Youssef P, Kaye R, Paskhover B. Facial Fractures in Young Adults: A National Retrospective Study. Ann Otol Rhinol Laryngol 2019;128:516-23. [DOI:10.1177/0003489419830114]
56. Othman S, Cohn JE, Toscano M, Shokri T, Zwillenberg S. Substance Use and Maxillofacial Trauma: A Comprehensive Patient Profile. J Oral Maxillofac Surg 2020;78:235-40. [DOI:10.1016/j.joms.2019.10.022]
57. Boffano P, Kommers SC, Karagozoglu KH, Forouzanfar T. Aetiology of maxillofacial fractures: A review of published studies during the last 30 years. Br J Oral Maxillofac Surg 2014;52:901-6. [DOI:10.1016/j.bjoms.2014.08.007]
58. Nogami S, Yamauchi K, Yamashita T, Kataoka Y, Hirayama B, Tanaka K, et al. Elderly patients with maxillofacial trauma: study of mandibular condyle fractures. Dent Traumatol 2015;31:73-6. [DOI:10.1111/edt.12129]
59. Gualtieri M, Pisapia F, Fadda MT, Priore P, Valentini V. Mandibular Fractures Epidemiology and Treatment Plans in the Center of Italy: A Retrospective Study. J Craniofac Surg 2021;32:E346-9. [DOI:10.1097/SCS.0000000000007118]
60. Patel N, Kim B, Zaid W. A Detailed Analysis of Mandibular Angle Fractures: Epidemiology, Patterns, Treatments, and Outcomes. J Oral Maxillofac Surg 2016;74:1792-9. [DOI:10.1016/j.joms.2016.05.002]
61. Agarwal P, Mehrotra D, Agarwal R, Kumar S, Pandey R. Patterns of Maxillofacial Fractures in Uttar Pradesh, India. Craniomaxillofac Trauma Reconstr 2017;10:48-55. [DOI:10.1055/s-0036-1597581]
62. Lee K, Olsen J, Sun J, Chandu A. Alcohol-involved maxillofacial fractures. Aust Dent J 2017;62:180-5. [DOI:10.1111/adj.12471]
63. Goulart DR, Durante L, De Moraes M, Asprino L. Characteristics of Maxillofacial Trauma Among Alcohol and Drug Users. J Craniofac Surg 2015;26:e783-6. [DOI:10.1097/SCS.0000000000002055]
64. Desai J, Lownie J, Cleaton-Jones P. Prospective audit of mandibular fractures at the Charlotte Maxeke Johannesburg Academic Hospital. S Afr J Surg 2010;48:122-6.
65. Chegeni M, Kamel Khodabandeh A, Karamouzian M, Shokoohi M, Abedi L, Khalili M, et al. Alcohol consumption in Iran: A systematic review and meta-analysis of the literature. Drug Alcohol Rev 2020;39:525-38. [DOI:10.1111/dar.13093]
66. Borna H, Rad SMBA, Borna S, Mohseni SM. Incidence of and risk factors for birth trauma in Iran. Taiwan J Obstet Gynecol 2010;49:170-3. [DOI:10.1016/S1028-4559(10)60036-8]
67. Ghorashi Z, Ahari HS, Okhchi RA. Birth injuries of neonates in Alzahra hospital of Tabriz, Iran. Pakistan J Med Sci 2005;21:289-91.
68. Hajiesmaello M, Hajian S, Riazi H, Majd HA, Yavarian R. Secondary traumatic stress in iranian midwives: stimuli factors, outcomes and risk management. BMC Psychiatry 2022;22:56. [DOI:10.1186/s12888-022-03707-7]
69. Kashkooe A, Yadollahi M, Pazhuheian F. What factors affect length of hospital stay among trauma patients? A single-center study, Southwestern Iran. Chinese J Traumatol 2020;23:176-80. [DOI:10.1016/j.cjtee.2020.01.002]
70. Mansouri M, Faghihi H, Hajizadeh F, Rasoulinejad SA, Rajabi MT, Tabatabaey A, et al. Epidemiology of open-globe injuries in iran: Analysis of 2,340 cases in 5 years (report no. 1). Retina 2009;29:1141-9. [DOI:10.1097/IAE.0b013e3181a395ac]
71. Barach P, Rivkind A, Israeli A, Berdugo M, Richter ED. Emergency preparedness and response in Israel during the Gulf War. Ann Emerg Med 1998;32:224-33. [DOI:10.1016/S0196-0644(98)70140-4]
72. Hennocq Q, Bennedjaï A, Simon F, Testelin S, Devauchelle B, Tulasne JF, et al. Maxillofacial surgery in wartime Middle-East: Paul Tessier's missions to Iran. J Craniomaxillofacial Surg 2019;47:1449-55. [DOI:10.1016/j.jcms.2019.06.007]
73. Hesamirostami M, Sarparast L, Radfar A, Hesamirostami S, Hosseinzadeh AZ, Yousefnezhad O. Choosing Appropriate Technique for Nasal Reconstruction in Challenging Cases of Panfacial Burn: Treatment Algorithm. J Burn Care Res 2021;42:1215-26. [DOI:10.1093/jbcr/irab036]
74. Jahromi HE, Gholami M, Rezaei F. A randomized double-blinded placebo controlled study of four interventions for the prevention of postoperative nausea and vomiting in maxillofacial trauma surgery. J Craniofac Surg 2013;24:e623-7. [DOI:10.1097/SCS.0b013e3182a2d896]
75. Khaqani MS, Tavosi F, Gholami M, Eftekharian HR, Khojastepour L. Analysis of Facial Symmetry After Zygomatic Bone Fracture Management. J Oral Maxillofac Surg 2018;76:595-604. [DOI:10.1016/j.joms.2017.10.005]
76. Khiabani K, Zinhaghayegh B, Amirzade-Iranaq MH. Does Dynamic Intermaxillary Fixation With Elastics Improve Outcomes Following Unilateral Condylar Fracture? J Oral Maxillofac Surg 2021;79:192-9. [DOI:10.1016/j.joms.2020.08.040]
77. Khiabani K, Ahmadfar M, Labafchi A, Gosheh MR, Samieirad S. Is Preoperative Administration of Tranexamic Acid Effective on Blood Loss Reduction in Mandibular Fracture Surgeries? A Triple-Blind Randomized Clinical Trial. J Oral Maxillofac Surg 2021;79:429.e1-429.e7. [DOI:10.1016/j.joms.2020.09.011]
78. Nasser M, Fedorowicz Z, Ebadifar A. Management of the fractured edentulous atrophic mandible. Cochrane Database Syst Rev 2007;1:CD006087. [DOI:10.1002/14651858.CD006087.pub2]

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