INDIAN DENTAL ACADEMY

Leader in continuing dental education

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MAXILLOFACIAL INJURIES









































GK / MAXFAC
SDM DHARWAD
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MAXILLOFACIAL INJURIES

FUNCTION

SMELL

SEE

TALK

GK / MAXFAC
SDM DHARWAD
APPEARANCE

EAT

HEAR

BREATHE






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MAXILLOFACIAL INJURIES
TRAUMA: PHYSICAL FORCE RESULTS IN INJURY
F = mv
2
ETIOLOGY
ASSAULTS
FALL
INDUSTRIAL ACCIDENTS
RTA
SPORTS INJURIES
WAR INJURIES

GK / MAXFAC
SDM DHARWAD
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MAXILLOFACIAL INJURIES

SERIOUS TRAUMA: DEATH
TRIMODAL DISTRIBUTION

SECONDS TO MINUTES
MINUTES TO HOURS
(GOLDEN HOUR)
AFTER DAYS
GK / MAXFAC
SDM DHARWAD
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MAXILLOFACIAL INJURIES
GOLDEN HOUR
COMPLICATIONS
UNRECOGNIZED SERIOUS


AIRWAY
CERVICAL SPINE
HAEMORRHAGE
GK / MAXFAC
SDM DHARWAD
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MAXILLOFACIAL INJURIES
GOLDEN HOUR

AIRWAY
BREATHING
CIRCULATION
DEFORMITY
EXPOSURE

GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
GOLDEN HOUR
AIRWAY
SUCTION
CHIN LIFT - JAW THRUST
AIRWAYS
CRICO / TRACHY
OXYGEN

GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
GOLDEN HOUR
BREATHING
CHEST INJURY
Pneumothorax
Cardiac tamponade
Ruptured diaphragm
GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
GOLDEN HOUR
CIRCULATION
I.V. ACCESS
TRANSFUSION
Hypovolemia- SHOCK

GK / MAXFAC
SDM DHARWAD
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MAXILLOFACIAL INJURIES
GOLDEN HOUR: CIRCULATION
Hypovolemic shock
Tachycardia
Hypotension
Cold clammy skin
Loss of peripheral pulse
Falling urinary output
Confusion & disorientation
GK / MAXFAC
SDM DHARWAD
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MAXILLOFACIAL INJURIES
GOLDEN HOUR
DISABILITY
Patients response AVPU
Awake
Verbal stimuli
Painful stimuli
Unconscious
GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
MAXILLOFACIAL INJURIES

DIAGNOSIS & TREATMENT PLAN

Eye witness report
Clinical diagnosis (ABCDE)
Neurological examination
- G.C.S
- Cranial Nerves


GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
EYE
OPENING
VERBAL RESPONSE
MOTOR
RESPONSE





























































































































































































































































































































































































































































































































































































































































































































































































GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
Secondary survey
ABDOMEN
Occult blood sequestration
Tenderness / acute abdomen
Gastric decompression (N.G tube)
Direct peritoneal lavage

GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
Secondary survey
EXTREMITIES

Reduced perfusion
Traumatic amputation
Compartmental Syndrome
Site for major blood loss
(1-6 units)
GK / MAXFAC
SDM DHARWAD
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GK / MAXFAC
SDM DHARWAD
MAXILLOFACIAL INJURIES
EXTRA-ORAL EXAMINATION
Inspection

Swelling
Hematoma
Skin lacerations / defects
Facial nerve
Mouth opening

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MAXILLOFACIAL INJURIES
EXTRA-ORAL EXAMINATION
Palpation
Tenderness
Crepitation
Contour irregularities (step)
Depressed / Penetrating
bone
GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
EXTRA-ORAL EXAMINATION
Soft tissues
(contusion tissue loss)

Foreign bodies
Nerves
Ducts
Blood vessels
(remember tetanus)

GK / MAXFAC
SDM DHARWAD
(NOSE / EAR / EYE) www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
INTRA-ORAL EXAMINATION
Inspection
Asymmetry, Swelling
Bleeding, Hematoma
Occlusal plane / Step deformity
Mucosal lacerations
Teeth: fracture
avulsion
dislocation
GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
INTRA-ORAL EXAMINATION
Palpation
Bimanual
Tenderness
# line / Step deformity
Crepitation
Teeth movement, Number
Missing parts
Sensory distribution V
1
- V
3
( SALIVARY GLANDS / TONGUE / PALATE )

GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
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

GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
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
( oblique / transverse / sagittal & degree of dislocation )
GK / MAXFAC
SDM DHARWAD
www.indiandentalacademy.com
MAXILLOFACIAL INJURIES
Classification of fractures





Additional features
Pathologic
Atrophic
Impacted
Direct / indirect (contra-coup)
Blow out / in
GK / MAXFAC
SDM DHARWAD
3) Anatomical Location
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For more details please visit
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Thank You
For more details please visit
www.indiandentalacademy.com
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