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INDIAN DENTAL
ACADEMYdental education
Leader in continuing
www.indiandentalacademy.com

www.indiandentalacademy.com
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
• FUNCTION

“APPEARANCE”

• SMELL

• EAT

• SEE

• HEAR

• TALK

• BREATHE
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
TRAUMA: PHYSICAL FORCE RESULTS IN INJURY

F = mv2
ETIOLOGY
• ASSAULTS
• FALL
• INDUSTRIAL ACCIDENTS
• RTA
• SPORTS INJURIES
• WAR INJURIES
GK / MAXFAC
SDM DHARWAD

www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
SERIOUS TRAUMA: DEATH
TRIMODAL DISTRIBUTION
• SECONDS TO MINUTES
• MINUTES TO HOURS
(GOLDEN HOUR)
• AFTER DAYS

www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
GOLDEN HOUR

COMPLICATIONS
UNRECOGNIZED SERIOUS

AIRWAY
CERVICAL SPINE
HAEMORRHAGE
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
GOLDEN HOUR

AIRWAY
BREATHING
CIRCULATION
DEFORMITY
EXPOSURE
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
GOLDEN HOUR
AIRWAY
• SUCTION
• CHIN LIFT - JAW THRUST
• AIRWAYS
• CRICO / TRACHY
• OXYGEN

www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
GOLDEN HOUR
BREATHING
CHEST INJURY
• Pneumothorax
• Cardiac tamponade
• Ruptured diaphragm
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
GOLDEN HOUR

CIRCULATION
I.V. ACCESS
TRANSFUSION
Hypovolemia- SHOCK

www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
GOLDEN HOUR: CIRCULATION

Hypovolemic shock
• Tachycardia
• Hypotension
• Cold clammy skin
• Loss of peripheral pulse
• Falling urinary output
• Confusion & disorientation
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
GOLDEN HOUR
DISABILITY
Patient’s response ‘AVPU’
Awake
Verbal stimuli
Painful stimuli
Unconscious
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
DIAGNOSIS & TREATMENT PLAN
Eye witness report
Clinical diagnosis (ABCDE)
Neurological examination

- G.C.S
- Cranial Nerves
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
EYE
OPENING

MOTOR
RESPONSE

www.indiandentalacademy.com

VERBAL RESPONSE

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
Secondary survey
ABDOMEN
Occult blood sequestration
Tenderness / acute abdomen
Gastric decompression (N.G tube)
Direct peritoneal lavage
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
Secondary survey
EXTREMITIES
Reduced perfusion
Traumatic amputation
Compartmental Syndrome
Site for major blood loss
(1-6 units)
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
EXTRA-ORAL EXAMINATION

Inspection
•

Swelling

•

Hematoma

•

Skin lacerations / defects

•

Facial nerve

•

Mouth opening

www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
EXTRA-ORAL EXAMINATION

Palpation
•

Tenderness

•

Crepitation

•

Contour irregularities (step)

•

Depressed / Penetrating
bone
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
EXTRA-ORAL EXAMINATION

Soft tissues

(contusion

tissue loss)
Foreign bodies
Nerves
Ducts
Blood vessels

(remember tetanus)

www.indiandentalacademy.com
(NOSE / EAR / EYE)

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
INTRA-ORAL EXAMINATION

Inspection
• Asymmetry, Swelling
• Bleeding, Hematoma
• Occlusal plane / Step deformity
• Mucosal lacerations
• Teeth: fracture
avulsion
dislocation
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
INTRA-ORAL EXAMINATION

Palpation
• Bimanual
• Tenderness
• # line / Step deformity
• Crepitation
• Teeth movement, Number
• Missing parts
• Sensory distribution V1 - V3
www.indiandentalacademy.com

( SALIVARY GLANDS / TONGUE / PALATE )

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
RADIOGRAPHIC EXAMINATION
(based on clinical examination)
Plain radiographs
Location & Severity of fractures
Radio-opaque foreign bodies

CT scans
Intra-cranial injuries
Orbital & naso-ethmoidal
injuries
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
Primary management (ABCDE)
Neurological assessment (GCS)
Control of pain
analgesics
Control of infection
antibiotics
Surgical planning

GK / MAXFAC
SDM DHARWAD

www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
Classification of fractures
1)Relation to overlying soft tissues
Closed / Simple
Open / Compound
Complicated

2)Type of fracture
Green stick
Single
Multiple
Comminuted

www.indiandentalacademy.com
( oblique / transverse / sagittal & degree of dislocation )

GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
Classification of fractures

3) Anatomical Location
Additional features
•

Pathologic

•

Atrophic

•

Impacted

•

Direct / indirect (contra-coup)

•

Blow out / in
www.indiandentalacademy.com

GK / MAXFAC
SDM DHARWAD
T
hank You

Leader in continuing dental education
www.indiandentalacademy.com

www.indiandentalacademy.com

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Editor's Notes

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