This document discusses traumatic injuries to the oral and facial structures and the importance of radiographic examination. It covers 1) common causes of trauma like accidents, falls, and assaults; 2) types of injuries to teeth including fractures, luxations, avulsions; 3) fractures of the mandible and midface bones; and 4) appropriate radiographic views needed to evaluate different types of injuries. Radiographs are important to assess fractures, displacement, relation to teeth, and presence of complications. Follow-up radiographs may also be needed.

1. Traumatic injuries
By Gihan Omar
Professor of Oral Radiology

2. Causes of trauma
Accidents

3. Falls
sports

4. Assault

5. Importance of radiographs:
• Presence of fracture
• Site and direction of fracture
• Degree of displacement
• Relation to teeth
• Presence of contributing disease
• Foreign bodies in hard and soft tissues
• Follow up
• Post traumatic complications

6. Traumatic injuries to teeth
Approximation of fracture to the pulp
Degree of development of the root
Detect fracture of the root
Importance of radiographic
Examination (cont)

7. 1- Concussion: crushing injury
Clinically

8. 2- Luxation
Dislocation of articulation and mobility

9. Luxation ……………..Extrusion

10. Luxation …………..Intrusion

11. 3- Avulsion
Complete displacement of tooth from its socket.

12. 4- Teeth fracture
Crown fracture

13. Root fracture
Horizontal fracture

15. Vertical and oblique
fractures of the root
PS: Vertical fracture

16. Radiographic examination of
trauma to teeth
• Two periapical radiographs of
different horizontal angulations
• Occlusal topographic
• Panorama
• Chest x-ray
• Radiograph of traumatized soft
tissues

17. Fracture of the mandible

18. Symphyseal fracture
occlusal radiographs
(topographic& cross-
sectional)
PA
panorama

19. Body fracture
panorama
PA
lateral oblique
occlusal

21. Angle fracture
panorama
PA
lateral oblique

22. Ramus fracturePanorama
 PA
lateral
oblique

24. Coronoid fracture
Panorama
lateral
oblique
 sinus

25. Condyle fracture

26. Panorama
TMJ views
 Towen`s
lateral oblique
tomograms
Children

27. Displacement of fractured segments

29. Two views at right angle
Or two views at different angles
CT

32. Radiological appearance of mandibular fracture

33. Radiographic appearance of fractures

36. Note: how the two fracture lines meet at the inferior cortex

38. 38
• Radiographic
limitations:

39. Fracture of facial
skeleton
1- maxillary fractures
Alveolar ridge fractures:
 periapical
 Occlusal topographic
 Postro-anterior
 panorama

40. 2- Midface fractures
may involve the maxilla alone or may involve other
bones (frontal, nasal, ethmoidal and sphenoidal)

41. Panorama
PA
waters`
SMV
CT for
complex
midfacial
fractures

42. Le forte 1
-Horizontal
fracture in the
maxilla
separating
tooth bearing
fragment from
middle face.

43. Le forte 1
PA
waters`
CT .

44. Le forte 2
- Maxilla is
separated
from base
of the skull.
- Nasal bones,
max sinus,
floor of orbit

45. PA
Tomograms
sinus
CT
Le forte 2

48. Le forte 3
 middle third of facial
bone from cranium.
 Orbital fractures,
ethmoid and
sphenoid sinus,
zygoma

49. Sinus
Tomograms
CT
Le forte 3

55. 3- Zygomatic fractures:
- zygomatic
arch
fracture
(unilateral
or
bilateral).
SMV
waters
Towne’s

57. Base of skull fractures
• CT

58. Facial bone fracture follow-up.
Inter and intra maxillary fixation IMF

61. What to do??

62. Now
relax
and
…. listen

63. by Louis Armstrong and Kenny G from the
album Classics in the Key of G
ENJOY
Please, let the show run on its own.
Music will start on next slide 

64. I see trees of green,

68. what a wonderful world

74. what a wonderful world

92. what a wonderful world

94. what a wonderful world.

95. Have a
wonderful week
end in a
wonderful world!!