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MAXILLOFACIAL INJURIES INDIAN DENTAL ACADEMY Leader in continuing dental education 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


THANK YOU For more details please visit www.indiandentalacademy.com

www.indiandentalacademy.com


Thank You For more details please visit www.indiandentalacademy.com

www.indiandentalacademy.com

Maxillofacial injuries (2)/ dental implant courses by 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 r...

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