Category Archives: Soft Tissue and Dentoalveolar Injuries


lacerations The general guidelines for management of facial lacerations are outlined in Chapter 23 ..Frequently, fractures of the facial bones are associated with severe facial lacerations. The principles of laceration repair remain’ the same regardless of how small or large the injury. ftG. 24-31 A, Patient (who ‘sustalned severe pantacial trauma from an industrial accident) in theoperating departme

Midface Fractures

Midface Fractures Treatment of fractures of the midface can be divided into those fractures that affeci, the occlusal relationship, such as Le Fort I, IC or III fractures, and those fractures that do not necessarily affect the occlusion, such as fractures of an isolated zygoma, zygomatic arch, or NO[‘ complex. Suspension ·wiring is sometimes used in addition to direct wiring or bone plating. The purpose

Mandibular Fractures

Mandibular Fractures The first and most important aspect of surgical correction is to reduce the fracture properly or place the individua  segments of the fracture into the proper relationship with FIG 24-17 each other. In the proper reduction of fractures of toothbearing bones, it is most important to place the teeth into the preinjury occlusal relationship. Merely aligning’ and interdigitattng-rhc bony


TREATMENT Of  FACIAL FRACTURES Whenever facial structures are injured, treatment must be directed toward maximal rehabilitation of the. patient . For facial fractures, treatment goals include rapid bone, healing; a return of normal ocular. masticatory; and nasal function; restoration of speech; and an acceptable facial . and dental esthetic result. During the treatment and healing phases, it is also important

Midface Fractures

Midface Fractures Midfacial fractures inciude fractures affecting the maxilla, the zygoma, and the NOE complex. Midfacial fractures can be classified as Le Fort I, II, or III fractures, zygomaticomaxillary complex (ZMC) fractures, zygomatic arch fractures, or NOE fractures. These injuries may be isolated or occur in combination. The most common type of midfacial fracture is the zygomatic complex fracture (Fig.

Mandibular Fractures

Mandibular Fractures Depending on thetype of injury and the direction and force of the trauma, fractures of the mandible commonly occur in several locations. One classification of fractures FIG. 24-11 Anatomic distribution of mandibular fractures. (From Olson RA et 0/:Fractures of the mandible: a reviev« of 580 cases, J Oral Maxillofac Surg 40:23,1982.) FIG. 24-12 Types of mandible fractures classified according


CAUSE AND CLASSIFICATION OF FACIAL FRACTURES Causes of Facial Fractures accidents are far more frequent in people who were not wearing ~estraints at the time of the accident . The major causes of facial fractures include motor vehicle accidents and altercations. Other causes of injuries include falls, sports-related :!~<‘i{I”l1t~. and work-related accldents.v’ Facial fractures resulting f

Radiographic Evaluation

Radiographic Evaluation After a careful clinical assessment of the facial area, radiographs should be taken to. provide additional information about facial injurles.? In cases of severe facial trauma, cervical spine injuries should be ruled out with a complete cervical spine series (i.e., cross-table,’ odontoid, and obliques views) befote any manipulation of the neck. The facial radiographic examination&

History and Physical Examination

History and Physical Examination After the patient has been initially stabilized, as complete a history as possible should be obtained. This history should be obtained from the patient; however, because of loss of consciousness or impaired neurologic status, information must often be obtained from witnesses or accompanying family members. Five important questions should be considered: (1) How did the accident


Immediate Assessment Before completing a detailed history and physical evaluation of the facial area, critical injuries that may be life threatening must be addressed. The first stein evaluar ing a trauma patient is to assess the patient’scardiopular,stability by ensuring that the patient has a patent airway andis adequately ventilated. Vital signs, including respiratory and pulse rates and blood pressur