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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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INDIAN DENTAL ACADEMY
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$MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiological features • Management www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Anatomy: • central support to cheek • buttress of lateral mid 3rd face Articulations: • Zygomatico-frontal •Zygomatico-maxillary • Zygomatico-temporal (arch) • Zygomatico-sphenoid(orbital floor) www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures ANATOMY Processes Maxillary Temporal Frontal Orbital Lateral wall and floor orbit Roof and lateral wall maxillary sinus www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures ANATOMY Arch Temporal Zygoma Maxilla Muscle attachments: Zygomaticus major / minor: malar eminence Levator labii superioris: infraorbital rim www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiological features • Management www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Mechanism of Injury Direct & Indirect In-bending at area of impact Out-bending of weak areas (distant) Dislocation posterior inferior medial lateral www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy •Clinical features • Radiological features • Management www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Clinical Features Flattening of cheek Periorbital edema / Ecchymosis Subconjunctival haemorrhage Epistaxis / Surgical emphysema Proptosis / Enophthalmos www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Clinical Features ENOPHTHALMOS • Inferior & posterior displacement • Expansion of orbit EXOPHTHALMOS • Medial dislocations www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Clinical Features Paresthesia (V2) / Pain !!! Trismus Tenderness / Step deformity Facial nerve weakness Drooping of upper lip DIPLOPIA www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Clinical examination Palpation: • Step / tenderness / mobility • Supra-orbital rim • F-Z suture • Infra-orbital rim • Paresthesia (lip, nose 14-11 + gingiva) www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiology • Management www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Radiographic examination Occipto-mental view (PNS view, Waters position) Fronto-zygomatic suture Zygomatico-maxillary buttress Inferior orbital rim www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Radiographic examination Submento-vertex view (jug handle view ) Zygomatic arch Posterior displacement www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Radiographic examination C.T. Scans: • Axial • Coronal www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiology • Management www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Immediate – primary care: • ABC • Nasal packs Anterior / Posterior • Control of pain • Control of infection - Tetanus!! • Prevent surgical emphysema www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Management • Restoration of form & function • Anatomic reduction • Treatment: “Surgical intervention” Closed v/s Open • Displacement & comminution • Exposure of fracture site • Alignment • Fixation www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Closed Reduction Arch fractures Minimal disruption (at 2 sutures) Intra-oral approach (Keen 1909) www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Closed Reduction • Temporal approach (Gillies 1927) www.indiandentalacademy.com$

Gillies Temporal Approach

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$MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Closed Reduction • Transcutaneous approach www.indiandentalacademy.com$

$MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Open Reduction & fixation F-Z Suture Infra-orbital rim & orbital floor Zygomatico-maxillary buttress (Intra-oral) www.indiandentalacademy.com$

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Complications
• Mal-union / Non-union / fibrous union
• Malocclusion
• Plate exposure
• TMJ disorders / Ankylosis
• Infection
• Nerve Damage (Paresthesia)
• Scars
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MAXILLOFACIAL INJURIES
Complications
Mal-union

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MAXILLOFACIAL INJURIES
Complications
Non-union

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MAXILLOFACIAL INJURIES
Complications
Fibrous union

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MAXILLOFACIAL INJURIES
Complications
Malocclusion

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MAXILLOFACIAL INJURIES
Complications
Plate Exposure / Wound dehiscence

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MAXILLOFACIAL INJURIES
Complications
Ankylosis

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MAXILLOFACIAL INJURIES
Complications
Infections

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MAXILLOFACIAL INJURIES
Complications
Scarring

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$MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiological features • Management •Complications www.indiandentalacademy.com$

MAXILLOFACIAL INJURIES

Mid face (Le-Fort) #

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Blow-out # of Orbit

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Fractures of the zygomatic complex are common facial injuries that often involve displacement of the zygomatic bone from its normal position. Clinical examination involves inspection for deformities and palpation of the zygomatic bone and arch. Radiographic evaluation with CT scanning is important to fully assess the fracture pattern and displacement. Successful management requires accurate reduction and fixation of the zygomatic bone to restore facial contour and function.

ZYGOMATICO MAXILLARY COMPLEX FRACTURE

Dr. Vishal Gohil

This document discusses fractures of the zygoma bone. It begins with an introduction and overview of fracture patterns, classification, clinical features, investigations, management approaches, reduction techniques, fixation methods, and complications. Key points include that zygoma fractures often involve adjacent structures like the maxilla and orbit. Fracture lines typically extend from the inferior orbital fissure in three directions. Clinical features may include facial deformity, diplopia, and neurological symptoms. Investigations include radiography and CT scanning. Surgical approaches to reduction include temporal, intraoral, and endoscopic methods. Fixation often utilizes miniplates applied at one to four points depending on the fracture pattern and displacement.

$Zmc fracture..by Dr.GPK/ Dr.G.P.Kumar/Dr.G.Padmanabha Kumar$ $Zmc fracture..by Dr.GPK/ Dr.G.P.Kumar/Dr.G.Padmanabha Kumar$

Zmc fracture..by Dr.GPK/ Dr.G.P.Kumar/Dr.G.Padmanabha Kumar

Padmanabha Kumar G.P.

1) Zygomatic fractures are the second most common fractures of the facial bones. The zygomatic bone forms a prominent part of the cheek and is susceptible to fractures. 2) Diagnosis involves clinical examination to identify deformities, step defects, and numbness as well as radiological imaging like CT scans. 3) Treatment aims to restore facial contour and nerve function through either closed or open reduction and fixation methods depending on the fracture pattern and degree of displacement.

$Zygoma fractures$ $Zygoma fractures$

Zygoma fractures

Satish Kumar

1) Fractures of the zygoma are commonly caused by road traffic accidents and assaults, with the left side more frequently involved than the right. 2) Classification systems categorize fractures based on the location and degree of displacement. Surgical approaches are determined by the fracture pattern and may involve extraoral or intraoral incisions. 3) Treatment involves closed or open reduction and fixation using methods like K-wires, plates and screws to properly align the zygomatic arch, frontal bone sutures, and orbital rim/floor. Complications can include sinusitis, malunion, diplopia or nerve numbness if not addressed correctly.

Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi..Zygomaticomaxillary com...

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zygomatic reduction,which comes when

Jamil Kifayatullah

This document discusses reduction techniques for zygomatic bone fractures. It begins by describing the anatomy of the zygomatic bone and common types of zygomatic fractures. It then outlines various surgical approaches that can be used for open reduction of zygomatic fractures, including the temporal fossa, intraoral, percutaneous, malar hook, Carroll Girard screw, and lateral eyebrow approaches. Indications for surgery include depressed malar eminence, enophthalmos, infraorbital paresthesia, and inability to open the mouth. The conclusion recommends that technique choice depends on the location and degree of displacement of the fracture.

$Zygomatic maxillary complex fracture$ $Zygomatic maxillary complex fracture$

Zygomatic maxillary complex fracture

josna thankachan

The document summarizes the zygomaticomaxillary complex fracture, including its anatomy, fracture patterns, classification systems, clinical features, investigations, management approaches, reduction techniques, fixation methods, and potential complications. Key points include that the fracture pattern typically involves 3 lines extending from the inferior orbital fissure in different directions, and management often involves open reduction and internal fixation using either a transoral/Keen's approach, Gillies temporal approach, or bicoronal approach depending on the fracture type and displacement. Complications can include nerve damage, malunion, enophthalmos, and infection.

This document discusses the classification, treatment approaches, and management of zygomatic fractures. It describes 8 types of zygomatic fractures based on the pattern of displacement. Treatment may involve either closed or open reduction with internal fixation using miniplates, wires, or pins placed through various surgical approaches. Postoperative care involves avoiding activities that could displace the fracture for several weeks to allow proper healing.

$Classification & management of zygomatic complex fractures including lateral ...$ $Classification & management of zygomatic complex fractures including lateral ...$

Classification & management of zygomatic complex fractures including lateral ...

Indian dental academy

$Condylar fractures$ $Condylar fractures$

Condylar fractures

Zeeshan Arif

This document discusses condylar fractures of the mandible. It begins by providing background on condylar fracture development, anatomy, surgical anatomy, blood supply, nerve supply and muscle attachments. It then covers the etiology, associated injuries, mechanisms of injury and various classification systems for condylar fractures. The document outlines the diagnosis process including history, clinical examination and radiographic imaging. It concludes by discussing treatment approaches, focusing on the aims of surgery and indications for conservative versus surgical management.

ZMC Fracture

Nitish Gupta

This document discusses zygomaticomaxillary complex fractures, including: - Anatomy of the zygoma and classification systems for ZMC fractures. - Clinical examination findings include flattening of the malar prominence and deformities of the orbital margin. - Radiographic evaluation includes Waters' view and CT scans to determine fracture pattern and displacement. - Treatment principles involve open reduction with or without fixation depending on fracture stability, with goals of restoring facial contour and function.

$Zygomatic complex fractures$ $Zygomatic complex fractures$

Zygomatic complex fractures

Mahak Ralli

This document discusses fractures of the zygomatic bone complex. It begins by describing the anatomy of the zygomatic bone and its connections. It then discusses the different types of zygomatic fractures based on the location and degree of displacement. The clinical features, investigations, classification systems, and approaches for open reduction and internal fixation are described. Complications from zygomatic fractures include infraorbital numbness, diplopia, enophthalmos, and traumatic optic neuropathy.

$Mandibular fracture closed reduction$ $Mandibular fracture closed reduction$

Mandibular fracture closed reduction

Dr. Akshay Shah

This document provides an overview of mandibular fractures, including anatomy, causes, classifications, signs and symptoms, diagnosis, and management. It describes the mandible bone and surrounding structures in detail. Common causes of mandibular fractures include motor vehicle accidents, assaults, and falls. Fractures are often classified based on location, number of fragments, occlusion, and other factors. Clinical exam may reveal swelling, pain, tooth mobility or avulsion, and malocclusion. Treatment options include closed or open reduction depending on the fracture type and stability. Closed reduction techniques like intermaxillary fixation or external pin fixation aim to realign fragments without surgery.

$Zygomatic arch fracture$ $Zygomatic arch fracture$

Zygomatic arch fracture

mostafa heeba

The document discusses various approaches for reducing fractures of the zygomatic arch. It describes the temporal (Gillies) approach which involves a temporal incision to access the arch. The trans-oral (Keen) approach uses a lateral maxillary vestibular incision for a more direct approach. Quinn's approach and the towel clip technique are also indirect approaches described for reducing depressed zygomatic arch fractures. A bi-coronal incision provides direct visualization of fractures involving multiple facial bones.

$Zmc fractures and management$ $Zmc fractures and management$

Zmc fractures and management

Bharath omfs

The document discusses zygomatic complex fractures, including: 1) Zygomatic fractures are common facial injuries that frequently involve fractures of the frontal, orbital, maxillary, and zygomatic processes. 2) Clinical examination involves inspection for asymmetries and palpation of the zygomatic area to assess for posterior displacement. 3) Diagnosis is aided by CT scan, which provides detailed images of fracture patterns and displacement of the zygomatic bone and surrounding structures.

ZYGOMATIC COMPLEX FRACTURE

Indian dental academy

$Zygomatic fractures$ $Zygomatic fractures$

Zygomatic fractures

DrDona Bhattacharya

This document discusses the anatomy, classification, diagnosis, and management of zygomatic complex fractures. It begins with the anatomical details of the zygomatic bone and its articulations. It then reviews various classification systems for zygomatic fractures, which typically categorize fractures based on the involved bone segments and degree of displacement. Common causes of these fractures are also mentioned. The diagnosis section outlines the clinical exam findings and imaging studies used to evaluate zygomatic fractures. Finally, the management section discusses indications for surgery, different surgical approaches, reduction techniques, and fixation methods like plates and screws. Complications of zygomatic fractures are also briefly outlined.

$Zmc fracture$ $Zmc fracture$

Zmc fracture

Ram Yadav

Zygomaticomaxillary complex (ZMC) fractures are the second most common facial fractures. They involve fractures of the zygomatic bone and its articulations with the maxilla, sphenoid, frontal, and temporal bones. Clinical signs include deformity of the zygomatic arch and orbital region, trismus, abnormal sensation, and epistaxis. Radiographic evaluation with CT scanning is important for classification and treatment planning. Treatment options include indirect reduction without fixation, indirect reduction with temporary packing, and direct open reduction with fixation when instability remains. Approaches for reduction include temporal, intraoral, percutaneous, transantral, and lateral brow incisions.

Orbital anatomy and trauma /certified fixed orthodontic courses by Indian den...

Indian dental academy

$Zygomatic complex fractures$ $Zygomatic complex fractures$

Zygomatic complex fractures

Ahmed Adawy

Zygomatic Complex Fractures Dr. Ahmed M. Adawy Professor Emeritus, Dept. Oral & Maxillofacial Surg. Former Dean, Faculty of Dental Medicine Al-Azhar University The term “zygomatic complex” refers to zygomatic bone and parts of maxilla, frontal, temporal and sphenoid bone. Fracture of the zygomatic complex, also known as a quadripod fracture, and formerly referred to as a tripod fracture, varies in severity from a simple crack to major disruption. The etiology, clinical presentations, and radiographic findings are presented. Classification systems are mentioned. The management of zygomatic complex fracture depends on the degree of displacement and the resultant esthetical and functional deficit. As a general rule, non- displaced or minimal displaced fracture can usually be treated conservatively. On the other hand, open reduction and internal fixation is applied in all dislocated, instable, and comminuted fractures of the zygomatic bone. Different surgical approaches and fixation methods are discussed.

$Maxillary and periorbital fractures$ $Maxillary and periorbital fractures$

Maxillary and periorbital fractures

Notre Dame De Chartres Hospital

This document discusses maxillary and periorbital fractures. It begins with an overview noting that these fractures are better thought of as orbitozygomaticomaxillary fractures. Precise anatomic reduction and functional and cosmetic rehabilitation are the goals. The document then covers epidemiology, mechanisms of injury, anatomy of the orbit, zygoma and maxilla, fracture patterns including LeFort fractures, patient evaluation including physical exam and imaging, and treatment approaches including surgical exposure options and techniques, internal fixation, and order of repairs.

Classification of Mandible, Midface, ZMC and NOE Fractures

Arjun Shenoy

Fx max orb-0001

airviper

This document provides an overview of maxillary and periorbital fractures, including: 1) It discusses the anatomy of the maxilla, orbit, and zygoma and describes common fracture patterns such as LeFort fractures and zygomatic fractures. 2) Evaluation and treatment are covered, emphasizing the importance of precise anatomic reduction through various surgical approaches and use of plates, meshes, and grafts. 3) Successful treatment aims to restore both function and cosmetic appearance through tailored repair of individual fractures.

$Condylar fractures /certified fixed orthodontic courses by Indian dental aca...$ $Condylar fractures /certified fixed orthodontic courses by Indian dental aca...$

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$Mandibular Condylar fractures & its Management$ $Mandibular Condylar fractures & its Management$

Mandibular Condylar fractures & its Management

Mehul Hirani

$Condylar fractures /certified fixed orthodontic courses by Indian dental ac...$ $Condylar fractures /certified fixed orthodontic courses by Indian dental ac...$

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Indian dental academy

Zygoma /certified fixed orthodontic courses by Indian dental academy

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$Mid face fractures / /certified fixed orthodontic courses by Indian dental ac...$ $Mid face fractures / /certified fixed orthodontic courses by Indian dental ac...$

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$Zmc fractures part 1$ $Zmc fractures part 1$

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04 zmc fracture

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$Classification & management of zygomatic complex fractures including lateral ...$ $Classification & management of zygomatic complex fractures including lateral ...$

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Indian dental academy

$Condylar fractures$ $Condylar fractures$

Condylar fractures

Zeeshan Arif

ZMC Fracture

Nitish Gupta

$Zygomatic complex fractures$ $Zygomatic complex fractures$

Zygomatic complex fractures

Mahak Ralli

$Mandibular fracture closed reduction$ $Mandibular fracture closed reduction$

Mandibular fracture closed reduction

Dr. Akshay Shah

$Zygomatic arch fracture$ $Zygomatic arch fracture$

Zygomatic arch fracture

mostafa heeba

$Zmc fractures and management$ $Zmc fractures and management$

Zmc fractures and management

Bharath omfs

ZYGOMATIC COMPLEX FRACTURE

Indian dental academy

$Zygomatic fractures$ $Zygomatic fractures$

Zygomatic fractures

DrDona Bhattacharya

$Zmc fracture$ $Zmc fracture$

Zmc fracture

Ram Yadav

Orbital anatomy and trauma /certified fixed orthodontic courses by Indian den...

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$Zygomatic complex fractures$ $Zygomatic complex fractures$

Zygomatic complex fractures

Ahmed Adawy

$Maxillary and periorbital fractures$ $Maxillary and periorbital fractures$

Maxillary and periorbital fractures

Notre Dame De Chartres Hospital

Classification of Mandible, Midface, ZMC and NOE Fractures

Arjun Shenoy

Fx max orb-0001

airviper

$Condylar fractures /certified fixed orthodontic courses by Indian dental aca...$ $Condylar fractures /certified fixed orthodontic courses by Indian dental aca...$

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$Mandibular Condylar fractures & its Management$ $Mandibular Condylar fractures & its Management$

Mandibular Condylar fractures & its Management

Mehul Hirani

$Condylar fractures /certified fixed orthodontic courses by Indian dental ac...$ $Condylar fractures /certified fixed orthodontic courses by Indian dental ac...$

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$Zmc fractures part 1$ $Zmc fractures part 1$

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$04 zmc fracture$ $04 zmc fracture$

04 zmc fracture

$Classification & management of zygomatic complex fractures including lateral ...$ $Classification & management of zygomatic complex fractures including lateral ...$

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$Condylar fractures$ $Condylar fractures$

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$Zygomatic complex fractures$ $Zygomatic complex fractures$

Zygomatic complex fractures

$Mandibular fracture closed reduction$ $Mandibular fracture closed reduction$

Mandibular fracture closed reduction

$Zygomatic arch fracture$ $Zygomatic arch fracture$

Zygomatic arch fracture

$Zmc fractures and management$ $Zmc fractures and management$

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ZYGOMATIC COMPLEX FRACTURE

$Zygomatic fractures$ $Zygomatic fractures$

Zygomatic fractures

$Zmc fracture$ $Zmc fracture$

Zmc fracture

Orbital anatomy and trauma /certified fixed orthodontic courses by Indian den...

$Zygomatic complex fractures$ $Zygomatic complex fractures$

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$Maxillary and periorbital fractures$ $Maxillary and periorbital fractures$

Maxillary and periorbital fractures

Classification of Mandible, Midface, ZMC and NOE Fractures

Fx max orb-0001

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$Lefort fractures /certified fixed orthodontic courses by Indian dental academy$ $Lefort fractures /certified fixed orthodontic courses by Indian dental academy$

Lefort fractures /certified fixed orthodontic courses by Indian dental academy

Indian dental academy

This document discusses the diagnosis and treatment of fractures of the middle third of the facial skeleton. It begins by outlining the phases of treatment for maxillofacial injuries - emergency care, early care, definitive care, and secondary care. It then goes into extensive detail about evaluating and managing the airway, controlling hemorrhage and shock, diagnosing fractures through imaging and examination, and approaches for surgically treating common midface fractures like Lefort I, II, and III fractures through open reduction and internal fixation. The goal is to restore facial anatomy and occlusion.

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ZMC Fracture.pptx

DentalYoutube

1) The document discusses zygomaticomaxillary fractures, providing classifications, examination techniques, signs and symptoms, and treatment approaches. 2) Common classification systems include the Knight and North system that categorizes fractures based on displacement patterns. Treatment depends on factors like displacement and stability. 3) Approaches to treatment include no treatment for non-displaced fractures, indirect reduction using techniques like the temporal or buccal sulcus approaches, and direct open reduction using approaches like the coronal or maxillary vestibular approaches with fixation if needed.

Tmj disorders 1 /certified fixed orthodontic courses by Indian dental academy

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 provides dental crown & Bridge,rotary endodontics,fixed orthodontics, Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call 0091-9248678078

Maxillofacial trauma /certified fixed orthodontic courses by Indian dental a...

Indian dental academy

This document provides an overview of maxillofacial trauma readiness training for dental officers. It covers evaluation and management of maxillofacial injuries in four phases: emergency care, early care, definitive care, and secondary care. Key points of emergency care include airway management, hemorrhage control, shock treatment, and C-spine stabilization. Early care involves initial fracture stabilization, debridement, diagnosis through imaging and examination. Definitive care consists of treating soft tissue injuries and fractures like mandibular and midface fractures through open or closed reduction methods. Midface fractures include Lefort I, II, III patterns. Nasal-orbital-ethmoid fractures often involve multiple midface structures.

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Facio maxillary injuries

rks sivasankar

This document provides an overview of facio-maxillary injuries, including their classification, diagnosis, and management. It discusses the phases of management, beginning with emergency care such as airway management and control of bleeding. It then covers initial care including stabilization of fractures and soft tissue injuries. Various types of soft tissue and skeletal injuries of the face are classified and their features and management are described. These include nasal, orbital, maxillary, zygomatic, and mandibular fractures as well as dental and nerve injuries. Investigation methods such as CT scanning are outlined. The roles of closed and open reduction techniques and rigid fixation are covered for treatment of fractures.

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Fixed appliences

Indian dental academy

1. Fixed orthodontic appliances deliver precise forces to teeth to correct malocclusions and include brackets, wires, and elastics. 2. The Begg and Edgewise techniques popularized the use of fixed appliances; Begg emphasized light forces while Edgewise allowed three-dimensional control. 3. Modern preadjusted appliances provide built-in tip and torque for improved control of tooth movement and alignment.

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Dear Doctor, Indian Dental Academy Now offers comprehensive online Orthodontics course. Course includes: 1.whiteboard lecture presentations 2.Case Discussions 3.with hundreds of pictures. 4.Demo on Models 5.Demo on Patients 6. subtitles in your own language 12 months unlimited access and support @350 USD only. For Demo please visit :www.idalectures.com/preview/ For more details visit: www.idalectures.com Please contact us for any clarifications: idalectures@gmail.com indiandentalacademy@gmail.com Thanks & Regards Indian Dental Academy -- Indian Dental Academy Leader in continuing dental education www.indiandentalacademy.com skype:indiandentalacademy +919248678078

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Zygoma & complications / /certified fixed orthodontic courses by Indian dental academy

1. MAXILLOFACIAL INJURIES INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com

2. MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiological features • Management www.indiandentalacademy.com

3. MAXILLOFACIAL INJURIES Zygomatic complex fractures Anatomy: • central support to cheek • buttress of lateral mid 3rd face Articulations: • Zygomatico-frontal •Zygomatico-maxillary • Zygomatico-temporal (arch) • Zygomatico-sphenoid(orbital floor) www.indiandentalacademy.com

4. MAXILLOFACIAL INJURIES Zygomatic complex fractures ANATOMY Processes Maxillary Temporal Frontal Orbital Lateral wall and floor orbit Roof and lateral wall maxillary sinus www.indiandentalacademy.com

5. MAXILLOFACIAL INJURIES Zygomatic complex fractures ANATOMY Arch Temporal Zygoma Maxilla Muscle attachments: Zygomaticus major / minor: malar eminence Levator labii superioris: infraorbital rim www.indiandentalacademy.com

6. MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiological features • Management www.indiandentalacademy.com

7. MAXILLOFACIAL INJURIES Zygomatic complex fractures Mechanism of Injury Direct & Indirect In-bending at area of impact Out-bending of weak areas (distant) Dislocation posterior inferior medial lateral www.indiandentalacademy.com

8. MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy •Clinical features • Radiological features • Management www.indiandentalacademy.com

9. MAXILLOFACIAL INJURIES Zygomatic complex fractures Clinical Features Flattening of cheek Periorbital edema / Ecchymosis Subconjunctival haemorrhage Epistaxis / Surgical emphysema Proptosis / Enophthalmos www.indiandentalacademy.com

10. MAXILLOFACIAL INJURIES Zygomatic complex fractures Clinical Features ENOPHTHALMOS • Inferior & posterior displacement • Expansion of orbit EXOPHTHALMOS • Medial dislocations www.indiandentalacademy.com

11. MAXILLOFACIAL INJURIES Zygomatic complex fractures Clinical Features Paresthesia (V2) / Pain !!! Trismus Tenderness / Step deformity Facial nerve weakness Drooping of upper lip DIPLOPIA www.indiandentalacademy.com

12. MAXILLOFACIAL INJURIES Zygomatic complex fractures Clinical examination Palpation: • Step / tenderness / mobility • Supra-orbital rim • F-Z suture • Infra-orbital rim • Paresthesia (lip, nose 14-11 + gingiva) www.indiandentalacademy.com

13. MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiology • Management www.indiandentalacademy.com

14. MAXILLOFACIAL INJURIES Zygomatic complex fractures Radiographic examination Occipto-mental view (PNS view, Waters position) Fronto-zygomatic suture Zygomatico-maxillary buttress Inferior orbital rim www.indiandentalacademy.com

15. MAXILLOFACIAL INJURIES Zygomatic complex fractures Radiographic examination Submento-vertex view (jug handle view ) Zygomatic arch Posterior displacement www.indiandentalacademy.com

16. MAXILLOFACIAL INJURIES Zygomatic complex fractures Radiographic examination C.T. Scans: • Axial • Coronal www.indiandentalacademy.com

17. MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiology • Management www.indiandentalacademy.com

18. MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Immediate – primary care: • ABC • Nasal packs Anterior / Posterior • Control of pain • Control of infection - Tetanus!! • Prevent surgical emphysema www.indiandentalacademy.com

19. MAXILLOFACIAL INJURIES Zygomatic complex fractures Management • Restoration of form & function • Anatomic reduction • Treatment: “Surgical intervention” Closed v/s Open • Displacement & comminution • Exposure of fracture site • Alignment • Fixation www.indiandentalacademy.com

20. MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Closed Reduction Arch fractures Minimal disruption (at 2 sutures) Intra-oral approach (Keen 1909) www.indiandentalacademy.com

21. MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Closed Reduction • Temporal approach (Gillies 1927) www.indiandentalacademy.com

22. Gillies Temporal Approach www.indiandentalacademy.com

23. MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Closed Reduction • Transcutaneous approach www.indiandentalacademy.com

24. MAXILLOFACIAL INJURIES Zygomatic complex fractures Management Open Reduction & fixation F-Z Suture Infra-orbital rim & orbital floor Zygomatico-maxillary buttress (Intra-oral) www.indiandentalacademy.com

25. MAXILLOFACIAL INJURIES Zygomatic complex fractures Management : Open Reduction F-Z Suture www.indiandentalacademy.com

26. MAXILLOFACIAL INJURIES Zygomatic complex fractures Management : Open Reduction Zygomatico-maxillary suture Infra-orbital rim www.indiandentalacademy.com

27. MAXILLOFACIAL INJURIES Complications • Mal-union / Non-union / fibrous union • Malocclusion • Plate exposure • TMJ disorders / Ankylosis • Infection • Nerve Damage (Paresthesia) • Scars www.indiandentalacademy.com

28. MAXILLOFACIAL INJURIES Complications Mal-union www.indiandentalacademy.com

29. MAXILLOFACIAL INJURIES Complications Non-union www.indiandentalacademy.com

30. MAXILLOFACIAL INJURIES Complications Fibrous union www.indiandentalacademy.com

31. MAXILLOFACIAL INJURIES Complications Malocclusion www.indiandentalacademy.com

32. MAXILLOFACIAL INJURIES Complications Plate Exposure / Wound dehiscence www.indiandentalacademy.com

33. MAXILLOFACIAL INJURIES Complications Ankylosis www.indiandentalacademy.com

34. MAXILLOFACIAL INJURIES Complications Infections www.indiandentalacademy.com

35. MAXILLOFACIAL INJURIES Complications Scarring www.indiandentalacademy.com

36. MAXILLOFACIAL INJURIES Zygomatic complex fractures • Applied surgical anatomy • Clinical features • Radiological features • Management •Complications www.indiandentalacademy.com

37. MAXILLOFACIAL INJURIES Mid face (Le-Fort) # www.indiandentalacademy.com Blow-out # of Orbit

38. Thank You www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

Editor's Notes

{"5":"Arch: contributions from three bones temporal, zygomatic & maxillary\nMuscle attachments\nNerves \nZ facial br of zygomatic nerve enters orbit through inferior orbital fissure divides into\nZ temporal which supplies area around zf suture & z facial which passes along inferior and lateral surface of the orbit exciting through a foramen on malar eminence to supply that area\nInfraorbital nerve through posterior margin of inferior orbital fissure, travels through a in its first 2/3rds of its course obliquely and medially across orbital floor and then through a canal in the infraorbital rim to exit the zygoma @ 1cm below the infraorbital rim grove \n","11":"Paresthesia V2 contusion or compression of nrve by bone fragments within the area of infraorbital foramen specially medially displaced fractures and will resolve only after elevation of fracture.\nLimitation in mouth opening due to swelling with in muscular and soft tissue planes, medially displaced arch, and posteriorly displaced body\n","17":"This should be the first slide\n","12":"Difference betwqeen proptosis & exopthalmos\n","1":"This should be the first slide\n","18":"Tetanus immunization schedule microbiology of tetanus check with dinesh \nFully immunised : last dose with in 10yrs .5ml toxoid\nPartially immunised: more than 10yrs .5ml toxoid\n","7":"Direct violent forces to cotralateral side can cause disruption of zygoma due to reciprocal transfer of forces but not common, bilateral zygoma fracutres are usually in association with other facial bones involved as in lefort 3 and is because of higher energy involvemnt. \nFractures are dislocated posteriorly,inferiorly & medialy are most frequent. Orbital #s are compressed with overlapping # fragments & while reducing, orbital fractures become more severe. These are impacted fractures\nMore extensive injuries are dislocated posteriorly inferiorly and laterally. The arch and soft tissue attachments must be disrupted to permit this.\nAny zygomatic complex fracture should include a discontinuity along the floor of the orbit.\nThe direction of dislocation involves the rotation of the bone in several planes this has resulted in several classifications\n","35":"1) Clossure of periosteal incissions\nPrevents lengthening of soft tissues soft tissue diastasis\n2) Refixation of tissues at several points of facial skeleton\nDue to inacurate allignment ( common in comminuted fractures)\nFix #ed Zygoma to adjacent unfractured bone Therefore expose unfractured land marks and use as guide\nCommonly seen at\ninfra orbital rim, and junction of orbital process of zygoma to greater wing of sphenoid\n","8":"This should be the first slide\n","36":"This should be the first slide\n","3":"Prominent position – frequently fractured\nEither alone or in combination with other bones of midface\nFractures include disruption of any of 5 articulations\n","9":"Loss of prominence of malar eminence may partially conceled by soft tissue swelling\nProptosis due to swelling with in muscular planes and tissue planes\nEchymosis and hematoma usually confined to distribution of orbital septum spectacle hematoma\nEpistaxis on ipsilateral nostril secondary to hemorrhage into maxillary sinus \n","4":"Articulates with \nzygomatic process of maxillary bone: infraorbital rim\nZygomatic process of temporal bone :in front of the glenoid fossa\nExternal angular process of frontal bone:to form fz suture\nWith in orbit articulates with medially orbital floor & laterally G.W.sphenoid\nBy virtue of its attachments\nForms floor & lateral wall of orbit & roof and lateral wall of maxillary sinus\n","10":"Clinical pictures to be added.\n"}

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Editor's Notes