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Maxillo facial injuries management  /certified fixed orthodontic courses by Indian dental academy
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078

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  • With reference to dentition dentulous and edentulous #s adults and children <br /> Dentulous jaw with posterior edentulous fragment ( otherwise an angle fracture of the mandible) <br />
  • Kazanzian & Converse <br /> Class I Teeth on both segments <br /> Class II teeth on one segment <br /> Class III Edentulous <br /> Rowe & Killey <br /> #s involving the basal bone <br /> #s not involving the basal bone <br /> favorable / unfavorable <br />
  • Inspection <br /> Inspection <br /> Hemorrhage <br /> Pain <br /> Swelling <br /> Altered occlusion <br /> Sublingual echymosis <br /> Halitosis <br /> Paraesthesia <br />

Maxillo facial injuries management /certified fixed orthodontic courses by Indian dental academy Presentation Transcript

  • 1. MAXILLOFACIAL INJURIES MANAGEMENT INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. MAXILLOFACIAL INJURIES MANAGEMENT Primary management (ABCDE) Neurological assessment (GCS) Control of pain analgesics Control of infection antibiotics Surgical planning www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 3. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES • Applied surgical anatomy • Classification • Clinical features • Radiological features • Management - immediate - definitive • Complications www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 4. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Applied surgical anatomy Curved bone Thickness of cortices Neurovascular bundle Dentition Attachment of Muscles GK / MAXFAC SDM DHARWAD www.indiandentalacademy.com
  • 5. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Applied surgical anatomy Muscle attachments: Depressors digastric geniohyoid Elevators temporalis masseter medial pterygoid GK / MAXFAC SDM DHARWAD www.indiandentalacademy.com
  • 6. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Applied surgical anatomy Areas of weakness •teeth •foramen •alveolar bone •angle •ramus •Condyle GK / MAXFAC SDM DHARWAD Blood supply Nerve supply www.indiandentalacademy.com
  • 7. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES •Applied surgical anatomy •Classification •Clinical features •Radiological features •Management - immediate - definitive •Complications www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 8. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification - Anatomical location - Relation to site of injury - Condition of fracture fragments - Type of displacement (angle) - # with reference to dentition www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 9. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification Anatomical site •symphysis •parasymphysis •body •angle •ramus •condyle •coronoidwww.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 10. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification - Anatomical location - Relation to site of injury - Condition of fracture fragments - Type of displacement (angle) - # with reference to dentition www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 11. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification Relation to site of injury -Direct -Indirect www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 12. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification - Anatomical location - Relation to site of injury - Condition of fracture fragments - Type of displacement (angle) - # with reference to dentition www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 13. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification Condition of fractured fragments Green Stick Simple Compound Comminuted www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 14. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification - Anatomical location - Relation to site of injury - Condition of fracture fragments - Type of displacement (angle) - # with reference to dentition www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 15. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification: type of displacement Angle of mandible Extraoral:Gonion Intraoral: Junction of alveolar bone and ramus Fracture of angle mandible Greater fragment :teeth bearing segment Lesser fragment: ramus GK / MAXFAC SDM DHARWAD www.indiandentalacademy.com
  • 16. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification Type of displacement (angle) favorable / unfavorable horizontal - vertical www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 17. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classificaton Fracture angle of mandible Displacement of Ramus (post edentulous fragment) Favorable: Minimal displacement Unfavorable: Gross displacement Viewed from side: Horizontal Viewed from www.indiandentalacademy.com above: Vertical GK / MAXFAC SDM DHARWAD
  • 18. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification - Anatomical location - Relation to site of injury - Condition of fracture fragments - Type of displacement (angle) - # with reference to dentition www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 19. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification # with reference to dentition Dentulous Child Adult Edentulous Dentulous jaw with a posterior edentulous fragment www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 20. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Classification Kazanzian & Converse Class I Teeth on both segments Class II teeth on one segment Class III Edentulous Rowe & Killey #s involving the basal bone #s not involving the basal bone www.indiandentalacademy.com favorable / unfavorable GK / MAXFAC SDM DHARWAD
  • 21. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Applied surgical anatomy Classification Clinical features Radiological features Management immediate definitive Complications www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 22. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Clinical Features Inspection Hemorrhage Pain Swelling Altered occlusion Sublingual echymosis Halitosis Paraesthesia www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 23. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Clinical Features Palpation Confirm inspectory findings Tenderness Fracture line/step Crepitation Paraesthesia Abnormal mobility www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 24. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Applied surgical anatomy Classification Clinical features Radiological features Management immediate definitive Complications GK / MAXFAC SDM DHARWAD www.indiandentalacademy.com
  • 25. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Radiographic features OPG / Lateral oblique P A mandible Intra oral occlusal view Confirms Site and severity of # Direction & displacement of # Condition of teeth in line of # Presence of bony pathology GK / MAXFAC SDM DHARWAD www.indiandentalacademy.com
  • 26. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Applied surgical anatomy Classification Clinical features Radiological features Management immediate definitive Complications www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 27. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management Objectives RESTORE FORM & FUNCTION Remember A B C D E Precise diagnosis Early reduction Adequate fixation and immobilization Rehabilitation / restoration of function www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 28. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management Immediate (Primary) ABCDE Temp immobilization Analgesics Antibiotics Diet & OHI www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 29. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management Definitive Reduction Fixation Immobilization Rehabilitation www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 30. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management REDUCTION Closed Advantages No need for a G.A Can be used in comminuted # Continuity defects ( gun shot injuries) Disadvantages Accuracy of reduction ambiguous Poor fracture alignment www.indiandentalacademy.com Inadequate reduction GK / MAXFAC SDM DHARWAD
  • 31. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management CLOSED REDUCTION AIM : Immobilization (IMF) •Ivy eyelet wiring •Direct wiring GK / MAXFAC SDM DHARWAD www.indiandentalacademy.com
  • 32. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management CLOSED REDUCTION AIM : Immobilization (IMF) •Arch Bar Wiring •Extra oral pin fixation GK / MAXFAC SDM DHARWAD www.indiandentalacademy.com
  • 33. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management REDUCTION Open Exposure of fracture skin / mucosa Direct reduction and fixation Transoseous Wiring Plate & Screw Osteosynthesis www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 34. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management Open REDUCTION Plate & Screw Osteosynthesis (Titanium/Stainless steel) Compression plates Mini plates Lag Screw GK / MAXFAC SDM DHARWAD www.indiandentalacademy.com
  • 35. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management REDUCTION Open Advantages Accurate reduction & fixation Alignment under direct visualization Disadvantages Need for a G.A & Hospitalization www.indiandentalacademy.com Expenses !!! GK / MAXFAC SDM DHARWAD
  • 36. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management Open REDUCTION Miniplate Osteosynthesis (Champy) Small malleable plate( 2 - 2.5 mm thickness) Trans oral approach No post op IMF www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 37. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management OPEN REDUCTION Miniplate Osteosynthesis Symphysis/Parasymphysis/body/angle Eyelets / Arch bars Temp IMF Intraoral Approach Exposure of fracture site(s) Curettage (haematoma) Reduction of Fracture Temporary Immobilization (IMF) www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 38. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management OPEN REDUCTION Miniplate Osteosynthesis Clinical applications Mini plate application & fixation Debridement & removal of IMF Recheck occlusion & Closure www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 39. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES • Applied surgical anatomy • Classification • Clinical features • Radiological features • Management - immediate - definitive • Complications www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 40. Thank You www.indiandentalacademy.com
  • 41. www.indiandentalacademy.com
  • 42. www.indiandentalacademy.com
  • 43. www.indiandentalacademy.com
  • 44. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management Edentulous mandibles Mostly simple #s Usually heals with out complications Displacement of # fragments variable Classification(Luhr et al) according to height of bone Class 1 : 16 - 20mm Class2 : 11- 15mm www.indiandentalacademy.com Class3 : less than 10mm GK / MAXFAC SDM DHARWAD
  • 45. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management Edentulous mandibles Treatment Methods Closed Reduction & Fixation Intra oral appliances: gunning splints dentures trimmed & relined (stabilized with Circumferential wiring) Extraoral pin fixation Immobilization period 4-6 weeks www.indiandentalacademy.com GK / MAXFAC SDM DHARWAD
  • 46. MAXILLOFACIAL INJURIES MANDIBULAR FRACTURES Management Edentulous mandibles Treatment Methods Open reduction & fixation Intraosseous wiring Primary rib grafting Reconstruction plate In bilateral body #s ( bucket handle # ) Precautions Avoid excessivewww.indiandentalacademy.com periosteal stripping GK / MAXFAC SDM DHARWAD
  • 47. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com