These bones grow from birth and fuse together to form the skull. Patients with condylar fracture and associated maxillofacial fratures like, lefort maxillary fractures, zygomatic complex fractures, nasal bone fractures, panfacial trauma and mandibular symphysis, body and angle fratures were excluded. The fracture occurs at the level of the piriform aperture and involves the anterior and lateral walls of the maxillary sinus, lateral nasal walls and, pterygoid plates. Fractures of the maxillary sinuses are usually coupled with cheekbone fractures. Maxillary and mandibular fractures occur from either direct or indirect blunt force to the facial bones. Maxillary fractures often result from highenergy blunt force injury to the facial skeleton. Le fort i describes a fracture separating the palate and alveolus from the rest of the maxilla. With increased legislation requiring seat belt use, injuries from driver impact with the steering wheel have shifted from chest trauma to facial trauma. In addition, in very highenergy blows, maxillary fractures may be associated with fractures to the mandible. Ppt maxillofacial trauma powerpoint presentation free. Example head ct image with maxillary sinus opacification. Maxillary sinusitis is inflammation of the maxillary sinuses. Maxillary fracture definition of maxillary fracture by.
Opacified bilateral maxillary sinuses and orbital emphysema fractures of. Maxillary and mandibular fractures pubmed central pmc. Ppt maxillofacial trauma powerpoint presentation free to. Maxillary artery injury associated with subcondylar. Prophylactic antibiotic therapy for fractures of the. View and download powerpoint presentations on mandibular fracture ppt. The facial bone ct confirms several nondisplaced fractured of the left maxillary sinus including a fracture at the. The adobe flash plugin is needed to view this content. Zygomaticomaxillary complex zmc fractures, also known as tripod, tetrapod, quadripod, malar or trimalar fractures, are seen in the setting of traumatic injury to the face. The maxillary sinus is one of the four paranasal sinuses, which are sinuses located near the nose.
In most instances, maxillary fractures are a combination of the various le fort types. The medical records of patients treated for maxillofacial injuries between may 2014 and november 2015 were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. The ability to apply a pure orthopedic force to the maxillary complex has so far eluded research efforts. Not only does this result in a disgruntled patient, it may affect their ability to continue to perform their occupation. Maxillary and periorbital fractures is the property of its rightful owner. Fractures of the jaw and midface injuries and poisoning. Mid facial fractures and their management slideshare. Clinical associate professor of surgery, division of head and neck surgery, university of california, san diego. Maxillary fracture definition of maxillary fracture by the.
Clinical associate professor of surgery, division of head and neck surgery, university. Extraction of upper first molar resulting in fracture of. The fracture also passes along the lateral wall of the nose and the lower third of the nasal septum to join the lateral fracture behind the tuberosity. Vincenzo guerini, history of dentistry 1909 lea and febiger philadelphia 2. Lefort i fracture is a horizontal maxillary fracture across the inferior aspect of the maxilla and separates the alveolar process containing the maxillary teeth and hard palate from the rest of the maxilla. Reevaluating the utility of maxillary sinus opacification as. Le fort i floating fracture guerin fracture low levelfracture subzygomatic fracture1. If there is a large maxillary tuberosity fracture, the aim is to salvage the fractured bone in place and to provide the best possible environment for healing. Bilateral maxillary sinus lift right side is planned as a staged sinus lift procedure with the surgical removal of the second bicuspid left side planned for. Facial trauma, maxillary and le fort fractures author.
Arterial supply internal maxillary artery from the external carotid. During the course of le fort fracture repair, the maxilla is mobilized and then placed into. In cases of isolated maxillary sinus fractures, you may notice air under the skin of the cheek or notice bleeding during nose blowing. Zygomaticomaxillary complex fracture radiology reference. The fracture line extends backwards from the lateral margin of the anterior nasal aperture below the zygomatic buttress to cross the lower third of the pterygoid laminae. The maxillary sinus is the largest of the paranasal sinuses. Moi direct horizontal or angular blow at the level of upper teeth but below the anterior nasal spine le fort i or horizontal maxillary fracture.
This is typically done with a ct scan of the head and can determine if there was any damage to the surrounding structures. Applied anatomy maxilla is composed of mainly 4 processes frontal zygomatic alveolar palatine its largest part of middle third of the face and contributes in the formation orbit, nasal cavity and hard palate. Assessment of head injury behavioral responses motor and verbal responses and eye opening. Zygomaticomaxillary complex fractures by dara liotta, md. These injuries often result from selfinflicted trauma such as falls or rearing with the jaw caught on a stationary object. A diagnosis of maxillary sinus fracture with conebeam ct.
Classic tripod, orbital floor, lefort fractures better thought of as. The nasal septum may also be fractured and the nasal cartilage may be buckled. Looking for online definition of maxillary fracture in the medical dictionary. In the adult, the upper wall or roof is thin and situated under the orbit. The skin over the involved sinus can be tender, hot, and even reddened due to the inflammatory process in the area. They can be satisfactorily reduced after this time but with each succeding day disimpaction becomes more difficult and open reduction more and more essential definitive treatment.
The fracture line extends through the floor of the nose, maxillary sinus, and pterygoid plates. Orthopedists view the mandible and maxillae as modified long bones into which can be placed all kinds of metallic implants, whereas veterinary dentists view the mandible and maxillae as a milieu of. Dec 19, 2014 maxillofacial injuries can be complex and multispecialty involvement in their management may be needed. A splint for fractures of the maxillary bones walter m.
Mandible is embryologically a membrane bent bone although, resembles physically long bone it has two articular cartilages with two nutrient arteries 1. Ppt midface fractures powerpoint presentation free to download id. Maxillary fractures types of maxillary fractures maxillary sagittal fracture maxillary sinus fracture palate fracture alveolar process fracture lefort fractures lefort i fracture lefort ii fracture. The maxillary sinus is the largest of the four paranasal sinuses and, being anatomically adjacent to the dentate region of the maxilla, is commonly. Maxillary mandibular fixation mmf methods are important techniques to master for the otolaryngologist, plastic surgeon, and oromaxillofacial surgeon who is caring for patients with jaw fractures and reconstruction needs. Facial trauma, also called maxillofacial trauma, is any physical trauma to the face.
The facial bone ct confirms several nondisplaced fractured of the left maxillary sinus including a fracture at the inferior orbital fissure. Techniques of maxillarymandibular fixation sciencedirect. Maxillary fractures are associated with a relatively high rate of complications, probably as a result of the highenergy nature of the trauma causing these injuries. Ppt mandibular and maxillary fractures powerpoint presentation free to download id. Sometimes it is called a blowout fracture when the fracture occurs in the floor lower part of the orbit. This section will discuss the facial bones of the skull. Reevaluating the utility of maxillary sinus opacification as a screening tool for facial bone fracture a decade after its original analysis figures etc.
Ppt midface fractures powerpoint presentation free to. Pdf a diagnosis of maxillary sinus fracture with cone. If a facial fracture is suspected, the best first thing to do is to ice it like crazy 20 min on, 20 min off in cycles throughout the day while awake, keep the head elevated even when sleeping, and take motrin for any paindiscomfort. Maxillary bone and le fort fractures see online here the human skull is a complex combination of several bones ranging from small to large sizes usually in pairs right and left side. If you think you have a sinus fracture then you should see a specialist to confirm the diagnosis. Pdf a diagnosis of maxillary sinus fracture with conebeam. Maxillary fractures are treated with surgery if they cause problems such as vision symptoms, a change in the way the teeth fit together, limitation of jaw opening, a sunken eyeball, facial numbness. For example, the eye and the nose or the mouth and the cheek can be damaged as a result of the same injury. Transverse maxillary fracture definition of transverse. In a pathological fracture, bones break, spontaneously and without trauma, due to certain diseases and conditions like cancer, osteomalacia, syphilis, and osteomyelitis, in a fracture due to direct violence, the bone breaks at the spot where the force. There are several signs and symptoms of a sinus fracture. Unfortunately, the incidence of maxillofacial trauma is increasing at an alarming rate.
With age, the enlarging maxillary sinus may even begin to surround the roots of the maxillary posterior teeth and extend its margins into the body of the zygomatic bone. These fractures are associated with older patients, in whom the maxillary sinus is more developed and the permanent teeth are erupted. Mandibular and maxillary fractures represent no less than a battlefield of strongly held beliefs when it comes to appropriate therapy. To the best of our knowledge, no published study has reported on cbct imaging of a maxillary sinus anterior wall fracture. Jan 12, 2015 the maxillary sinus is one of the four paranasal sinuses, which are sinuses located near the nose. Management of mandibular fracture authorstream presentation. Ellis class iv fracture is defined as the traumatized teeth that become nonvital with or without loss of crown structure.
Extraction of upper first molar resulting in fracture of maxillary tuberosity article in dental traumatology 251. Craniomaxillary orthopedic correction of the skeletal imbalance of class ii malocclusions is often the desired method of treatment in these cases. Nosesinusfacial fractures, trauma ent services in arizona. Orbital floor blowout fracture, nasal bone fracture, nasoorbitalethmoid fracture, lefort fracture and maxillary guerin fracture prophylaxis the use of restraints, seat belts, and protective headgear can help prevent zmc fractures. A heretofore unreported type of facial fracture is discussed. Maxillary and periorbital fractures slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Jun 14, 2016 segmental, depressed fractures of the posterolateral maxillary sinus may occur as a result of trauma to the masticator space, previously described in association with mandibular fractures. Maxillary fracture, right side, subsequent encounter for fracture with routine healing. Generally, an ebook can be downloaded in five minutes or less. Find powerpoint presentations and slides using the power of, find free presentations research about mandibular fracture ppt. If so, share your ppt presentation slides online with. If you continue browsing the site, you agree to the use of cookies on this website. The fracture extends from the nasal septum to the lateral pyriform rims, travels horizontally above the teeth apices, crosses below the zygomaticomaxillary junction, and traverses the pterygomaxillary junction to interrupt the pterygoid plates.
A free powerpoint ppt presentation displayed as a flash slide show on id. Management of traumatic injury to maxillary central. The maxillary sinus is pyramidal in shape with its base at the nasoantral wall and its apex in the root of the zygoma. If the maxillary posterior teeth are lost, the maxillary sinus may expand even more, thinning the bony floor of the alveolar process so that only a thin shell of bone is present. The concept of mmf has been used for the treatment of jaw and dental issues for more than 2000 years. Fracture of the nasal bone or the nasal septum lateral nasal injuries anterior nasal injuries b. Kris s moe, md, facs, chief, division of facial plastic and reconstructive surgery, department of otolaryngologyhead and neck surgery, university of washington school of medicine.
A splint for fractures of the maxillary bones sciencedirect. Guerin fractures or low level result from a force of injury directed low on the maxillary alveolar rim in a downward direction escapes diagnosis 32. The technique is suitable for imaging maxillofacial hard tissue as well as dental applications. Scribd is the worlds largest social reading and publishing site. Maxillary fractures comprise 628 % of all facial fractures. The maxillary artery lies in close relation to the medial cortex of the subcondyle and is vulnerable to injury by the sharp edges of the fracture fragments. Visit here to download this ebook sprengersspitzen. Ppt maxillary and periorbital fractures powerpoint. Dentoalveolar fracture an overview sciencedirect topics. Francis quinn, md grand rounds january 7, 2003 department of otolaryngology, utmb a free powerpoint ppt presentation displayed as a flash slide show on id.
Overlooking a fracture may not have immediate consequences, but can result in disfigurement and permanent disability. Maxillofacial fractures 1 ct is both the stateoftheart and the current standard of care for maxillary fracture evaluation. Mar 04, 2014 heiland et al stated that the use of cbct for preoperative, intraoperative, and postoperative imaging can decrease radiation doses in cases of zygomaticomaxillary complex fractures, while ct crucial in cases where there are neurological symptoms or severe injuries. The optimum time for reduction of midface fractures is usually between the fifth to eighth post injury day.
Mobility of maxillary alveolar segment floating fracture2. Typical mechanisms of trauma include motor vehicle accidents, altercations, and falls. Mandible fractures commonly occur in patients who have sustained blunt facial trauma, and the subcondylar region is the most frequently fractured due to its intrinsic biomechanical weakness. The authors hypothesize that the fracture is due to a transient increase in pressure in the masticator space blow out and therefore should be seen in association with other regional fractures. Lefort ii fracture pyramidshaped maxillary fracture, involving maxillarysinuses anteriorlateral walls, inferior orbital rim, orbitalfloor and nasofrontal suture clinical.
Le fort fractures types, clinical features and various types of management slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Click here for the professional version click here for the professional version injuries to the face often occur in combination. Mandibular and maxillary fractures 2 list 3 considerations in repair of mandibular fractures caused. Jun 17, 2018 le fort i fractures horizontal may result from a force of injury directed low on the maxillary alveolar rim in a downward direction. It is divided into rostral and caudal compartments by an oblique bony septum that continues dorsally into a thin, domed structure, the maxillary septal bulla formerly incorrectly termed the ventral conchal bulla. Arterial supply internal maxillary artery from the external carotid inferior alveolar artery through the mandibular foramen mental artery through the mental foramen. The incidence of malocclusion after the treatment of maxillary fractures ranges from 8% to 20%. The maxillary tuberosity is especially important for the stability maxillary maxillary of upper dentures and may cause a mouthsinus comminication oroantral communication. The proposed mechanism for this injury is an impact from the ipsilateral mandibular coronoid process striking the posterior maxillary wall, with associated mandibular dislocation or fracture. Initial evaluation and management of maxillofacial injuries. Isolated fractures of the posterior maxillary sinus. Maxillofacial trauma mandibular fractures long canine tooth and partially erupted wisdoms represent line of relatively weakness. Le fort fractures types, clinical features and various types of management.
Fracture lines often diverge from the described pathways and may result in mixedtype fractures, unilateral fractures, or other atypical fractures. When one or more bones are broken in the eye socket it is called an orbital fracture. Teenage years cause a significant number of dental injuries as they engage in contact sports. These are specific to the location of the affected sinus. Download netter s surgical anatomy and approaches, 1e netter clinical scienc. Facial trauma can involve soft tissue injuries such as burns, lacerations and bruises, or fractures of the facial bones such as nasal fractures and fractures of the jaw, as well as trauma such as eye injuries. Lefort or maxillary fractures zygomaticomaxillary complex fractures orbitozygomaticomaxillary complex fractures. The symptoms of sinusitis are headache, usually near the involved sinus, and foulsmelling nasal or pharyngeal discharge, possibly with some systemic signs of infection such as fever and weakness. Injury can involve the skin and soft tissues as well as resulting in fractures. The fracture pattern is defined by stating the highest level of le fort fracture on each side up to and including the frontal bone and the nature of the fragment that includes the maxillary dentition i. Motor vehicle accidents, assaults, and falls are the major reasons for maxillary fractures 1, 3, 6, 7. Murr, in complications in head and neck surgery second edition, 2009.
465 540 1559 74 1335 431 333 938 284 877 1482 1516 213 1202 1249 981 1052 1504 929 1235 1228 1593 404 1103 1057 987 386 677 132 1147 644 836 1039 1156 232 696 205 59 986 826