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Facial Trauma Cause, Treatment, and Diagnosis
Traumatic facial injuries have been noticed majorly in India. Interpersonal violence, falls, motor vehicle crashes and sport related injuries make up the majority of etiologies for these injuries.1 Since the advent of seat belts and air bags, there has been a significant decline in severe facial trauma as was seen in the ’60s, ’70s and ’80s.2 However, occasionally and unfortunately these injuries still occur. OMF surgeons on a regular basis deal with isolated facial fractures – mandibles, maxillae, zygomas, orbits, noses and frontal bones.
For the most part these can be managed acutely, perhaps with the exception of nasal fractures where it can be helpful to wait for resolution of swelling since many of these are treated by closed reduction.
Even the fractured zygomatico-maxillary complex can be managed and often treated from an intraoral approach, anatomically reduced and fixated in the presence of gross facial edema. The days of the ‘Gillies’ lift technique are being replaced by the intra oral buttress or other approaches with rigid fixation.3,4 These facial fractures are often thought of as easy fixes for OMF surgeons as it is simply a matter of putting the pieces of the puzzle back together; there is no occlusion to deal with!
Jaw fractures on the other hand represent a bigger challenge to achieve anatomic reduction such that the occlusion is normalized after the repair. This is especially so when rigid fixation (plates and screws) is utilized without a requirement for maxillo-mandibular fixation. Most patients, when offered the choice, would rather be ‘plated’ than ‘wired’ to fix their fractured jaw. On a regular basis we have seen patients referred to us with a fractured mandible or maxilla from their general dentist after that individual attended an emergency room and was sent home undiagnosed! After all some jaw fractures have slight or no displacement and the individual may look uninjured, however the complaint of a subtle malocclusion leads their dentist to suspect a fracture.At Global dental Centre we ensure no required diagnosis is unturned. We find these cases to be quite interesting and challenging.The services offered by GDC, Indoreare quite appreciated by the medical personnel and more so the patients.