Oral and maxillofacial surgery/Maxillofacial trauma

Taha tj (talk) 01:23, 7 July 2012 (UTC)

Maxillo-Facial Surgical Dentistry:
Traumatic injuries to face and jaws as well as congenital anomalies lead to Maxillo-facial surgeries.

Aetiology:
1. Road traffic accidents: Could effect the pedestrians, driver or other passengers but the most commonly affected is the front seat passengers. The effect depends on the magnitude of the impact. Motorcyclists frequently sustain maxillo-facial injury if using open-faced crash helmets and involved in a road traffic incident. 2. War injuries, effect of bullets shrapnel etc. 3. Civilian accidents, like industrial, athletic and home accidents. 4. Altercations (interpersonal violence). 5. Animal bites or kicks.

There are two type of wounds Open wounds & Close wounds:

Open Wounds
can be divided into four types:
 * 1) a)Cut wounds: It is Similar to a surgical wound. The skin and a variable amount of underlying tissues are cleanly cut by a sharp object or instrument but if its grossly infected or contaminated this kind of wound heals nicely if accurately sutured.
 * 2) b)Lacerated Wounds: It is caused by a less sharp instrument. The edges of the wound are lacerated. The wound is typically irregular with ragged edges which are somewhat confused and often not viable.Treatment is to excise confused edge of  wound thus converting it into a clean surgical wound and then suturing it accurately.
 * 3) c)Punctured Wounds: The entry wound is simple puncture usually caused by bullets.It should be realized that extensive damage has been done in depth of wound.Blood clot and damaged tissues is very liable to infection and usually damage is more serious than it first appears.
 * 4) d)Tissue Loss Wounds: Amount of skin or underlying structure may be lost or destroyed.Special problem of repair needs proper assessment for treatment.

Closed Wounds
can also be divided into three types:
 * 1) a)Contusion(Bruise): Crushed skin and underlying structures to some extent damaging small blood vessels and leading to extravasation of blood into tissues. Bluish discoloration, subsequently changing to yellow as extravasated blood undergoes breakdown into haemosiderin. The tissue often turns edematous.
 * 2) b)Haematoma: Injury lead to bursting of a bigger blood vessel with a localized extravasation of blood.Then coagulates and may subsequently re-liquefy before it is finally absorbed. If it lies near the surface, it is liable to become infected, The infected haematoma then becomes an abscess.
 * 3) c)Blast Injury: It is seen in both circumstances of air blast and underwater blast. Body is subjected to a sudden violent  positive and negative pressure wave. Ruptures small vessels throughout the body and leads to widespread wave petechial haemorrhages.

Signs and Symptoms of Maxillo Facial Injuries:

 * Facial deformity.
 * Ecchymosis.
 * Edema.
 * Soft tissue wound over bony eminences.
 * Malocclusion of teeth (open bite, cross bite etc.)
 * Trismus.
 * Functional disability.
 * Bleeding from ear or nose or C.S.F. discharge from them.
 * Bimanual palpation results in abnormal mobility and tenderness.
 * Diplopia.