1. RADIGRAPHIC EXAMINATION
IN MAXILLOFACIAL TRAUMA

2. Radiological examination
 Useful diagnostic aid.
 Radiation cost
 Financial cost
 Urgency of the treatment.

3. Projections for facial fractures
 For fractures of middle third of the face
- Occipitomental view
- Submentovertex view
- Lateral skull
- PA view – water’s position

4.  For zygomatic complex fracture
- Occipitomental view
- Submentovertex view
- PA view – water’s position
 For mandibular fractures
- OPG
- Right & left lateral oblique view of
mandible
- PA view of mandible

5. Radiological interpretation of
facial trauma
You see what you look for…!!!!

6.  Occipitomental projection
 Fractures & other signs are
commonly found.
Campbell’s and trapnell’s lines

7. Dolan & Jacoby’s line
A) Orbital line.
B) Zygomatic line.
C) Maxillary line.

8. 4 ‘S’ by Delbalso et al
 Symmetry.
 Sharpness – Bright sign, Trapdoor sign.
 Sinus.
 Soft tissues.
foreign bodies, emphysema.

9. HOT sites of fracture on
face.

10. Radiographic signs of fracture.
 Separation sign.
 Sutural diastasis.
 Overlap sign.
 Abnormal linear density
 Disappearing fragment sign.
 Abnormal angulation.
 Step deformity

11. Indirect signs.
 Soft tissue swelling.
localized – attention to that part
 Paranasal sinus opacification.
 Air in the soft tissues.

12. CT scan
 Provides images in thin slices,
avoid superimposition of
structures.
 Increased contrast- foreign
bodies.
 Axial CT scan – transverse
plane.
 Coronal CT scan – orbital
examination

13.  MRI- soft tissue injury, CSF leak.
Recent advances
 Spiral & Multislice CT
- Much faster & can provide 9
times larger image.
- High quality reconstruction.
 3D CT scan.
 Angiography,
arthrography.

14. Conclusion.
Surgical
outcome
Treatment
planning
Accurate diagnosis
Careful clinical examination

15. References.
 Oral & maxillofacial trauma- Fonseca,vol 1
 Maxillofacial Injuries- Rowe & Williams
 Textbook of oral & maxillofacial surgery by Peter
Ward Booth.