Mid face fractures / /certified fixed orthodontic courses by Indian dental academy

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Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients

State of the art comprehensive training-Faculty of world wide repute &Very affordable.

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Mid face fractures / /certified fixed orthodontic courses by Indian dental academy

  1. 1. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Temporal Frontal Maxilla Zygoma Nasal Ethmoid Sphenoid Vomer Palatine Lacrimal #s are multiple www.indiandenalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiadentalacademy.com www.indiandenalacademy.com
  3. 3. MAXILLOFACIAL INJURIES MIDFACE FRACTURES • Applied surgical anatomy • Classification • Clinical features • Radiological features • Management www.indiandenalacademy.com
  4. 4. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Applied surgical anatomy •Link cranial base to occlusal plane •Protect base of skull •Thin lamellar bone •Blood supply www.indiandenalacademy.com
  5. 5. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Applied surgical anatomy Protect base of skull Vertical buttresses (Sicher & Tandler 1928) www.indiandenalacademy.com
  6. 6. MAXILLOFACIAL INJURIES MIDFACE FRACTURES • Applied surgical anatomy • Classification • Clinical features • Radiological features • Management www.indiandenalacademy.com
  7. 7. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Classification 1886 Alphonse Guerin 1901 Rene Le Fort Le-Fort I, II & III www.indiandenalacademy.com
  8. 8. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort I Fracture (Guerin # / Low level # / Floating #) Nasal floor Pyriform rim Zygomatic buttress Pterygoid lamella Lateral wall nose Nasal septum tuberosity www.indiandenalacademy.com
  9. 9. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort II Fracture ( Pyramidal # / Subzygomatic # ) Nasal bone Frontal bone Orbit Lacrimal bone Infraorbital foramen Maxillary antrum ZM suture www.indiandenalacademy.com
  10. 10. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort III Fracture ( High transverse/Suprazygomatic/Craniofacial disarticulation) Fronto-nasal suture Ethmoid cribriform plate Frontal process maxilla Medial wall orbit Optic foramen Inferior orbital fissure Pterygoid lamella Lateral wall of orbit Z-F suture www.indiandenalacademy.com
  11. 11. MAXILLOFACIAL INJURIES MIDFACE FRACTURES • Applied surgical anatomy • Classification • Clinical features • Radiological features • Management www.indiandenalacademy.com
  12. 12. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Clinical features Swelling Ecchymosis Mobility Deranged occlusion Loss of function www.indiandenalacademy.com
  13. 13. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort I : Clinical features Swelling Ecchymosis Mobility Deranged occlusion Loss of function cracked pot sound ? mid palatal split : minimal : intra oral, palate, sulcus : floating # : post gagging,  V. D. www.indiandenalacademy.com
  14. 14. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort II / III : Clinical features Swelling : gross; (moon face) eyelids conjunctiva Ecchymosis : bilateral circum-orbital (panda face/raccoon face) Mobility : nasal bones, maxilla Infra orbital step (Le Fort II) www.indiandenalacademy.com
  15. 15. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort II / III : Clinical features Deranged occlusion: post gagging  V. D Dish face Loss of function: Diplopia? Anosmia Nares filled with clotted blood Emphysema, Epiphora, CSF Rhinorrhea,Hooding of eye www.indiandenalacademy.com
  16. 16. MAXILLOFACIAL INJURIES MIDFACE FRACTURES CSF Rhinorrhea Le-Fort II / III #s Dural tear # cribriform plate Meningitis ?? Diagnosis Clinical - Tram track, halo effect Biochemical - Dipstick -  glucose levels Radiological CT scan Radio opaque dye - sub arachnoid space www.indiandenalacademy.com
  17. 17. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Bilateral hooding of eyes Le-Fort II / III # Separation of F-Z suture Suspensory ligament of Lockwood Attachment medially - lacrimal bone laterally - below F-Z suture www.indiandenalacademy.com
  18. 18. MAXILLOFACIAL INJURIES MIDFACE FRACTURES • Applied surgical anatomy • Classification • Clinical features • Radiological features • Management www.indiandenalacademy.com
  19. 19. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Radiographic examination RADIOGRAPHS PNS view PA skull CT SCANS Axial & Coronal Views www.indiandenalacademy.com
  20. 20. MAXILLOFACIAL INJURIES MIDFACE FRACTURES • Applied surgical anatomy • Classification • Clinical features • Radiological features • Management www.indiandenalacademy.com
  21. 21. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Management ABCDE Reduction & fixation Closed v/s Open www.indiandenalacademy.com
  22. 22. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort I fractures ORIF plates Intra oral approach Fixation of plates after reduction Pyriform rim Zygomatic buttress www.indiandenalacademy.com
  23. 23. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort II fractures ORIF plates Nasal #s Infra orbital rim Zygomatic buttress www.indiandenalacademy.com
  24. 24. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort III fractures ORIF plates Fronto-zygomatic Fronto-nasal Zygomatic buttress www.indiandenalacademy.com
  25. 25. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort I, II & III fractures CLOSED Reduction & Fixation Suspension wires to mandible Frontal: Central & lateral Circum zygomatic www.indiandenalacademy.com
  26. 26. MAXILLOFACIAL INJURIES MIDFACE FRACTURES Le-Fort I, II & III fractures CLOSED External fixation Cranio-mandibular Box, Halo frames POP head cap www.indiandenalacademy.com
  27. 27. MAXILLOFACIAL INJURIES MIDFACE FRACTURES • Applied surgical anatomy • Classification • Clinical features • Radiological features • Management www.indiandenalacademy.com
  28. 28. T hank You www.indiandenalacademy.com

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