Abstract
Purpose: Treatment strategies for mandibular fractures vary among institutions and often depend on the surgeon’s experience. The purpose of this study was to evaluate treatment preferences for mandibular fractures among members of the Japanese Society of Maxillofacial Traumatology and to assess changes in clinical decision-making following expert-led educational intervention using a real-time voting system.
Methods: Ninety participants attended the educational seminar and were included in this survey-based study. Three clinical cases were presented: （1） bilateral condylar process fractures in a young adult, （2） condylar head fracture in an elderly patient, and （3） mandibular fracture in a pediatric patient. For each case, three treatment options were provided. Participants first voted for their preferred treatment strategy. Subsequently, three experts in maxillofacial trauma presented their respective treatment approaches supported by personal clinical cases and rationale. After the presentations, participants voted again on the same cases. Finally, participants were asked whether they had changed their initial answer （Yes/No）.
Results: Changes in treatment selection were observed in all three cases after the expert presentations. In the young adult case, preference shifted from “ORIF for all fractures” to “ORIF limited to the basal fracture.” In the elderly case, selection of intermaxillary fixation decreased, while preference for functional conservative management （pumping therapy） increased. In the pediatric case, the proportion selecting titanium plate fixation increased, whereas preference for resorbable plates decreased. Overall, 59 participants （65.6%） reported changing their initial answer after the seminar.
Conclusion: Considerable variability exists in treatment strategies for mandibular fractures among society members. Expert-led educational intervention influenced clinical decision-making in approximately two-thirds of participants. This interactive seminar format may serve as an effective educational tool to visualize differences in treatment strategies and promote knowledge sharing in maxillofacial trauma management.
