Mandibular fractures / oral surgery courses
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats. Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics, Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call 00919248678078
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Mandibular fractures / oral surgery courses
- 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
- 3. FRACTURE FRACTURE IS DEFINED AS A SUDDEN, VIOLENT SOLUTION OF CONTINUITY OF BONE AND MAY BE COMPLETE OR INCOMPLETE IN CHARACTER. FRACTURE MAY BE FROM: 1. Direct violence 2. Indirect violence 3. Excessive muscular contraction. www.indiandentalacademy.com
- 4. Mandibular fractures Etiology of mandibular fractures. R.T.A.------------------------------- 43% Assaults-------------------------------34% Work related------------------------ 7% As a result of fall------------------- 7% Sporting accidents------------------ 4% www.indiandentalacademy.com
- 5. Incidence of www.indiandentalacademy.com fracture at different site.
- 6. Classification According to Dorland’s medical dictionary Simple Compound Comminuted Greenstick Pathologic Multiple Impacted Atrophic Indirect Complex www.indiandentalacademy.com
- 7. Based on the anatomic region by Dingman and Natvig Midline Parasymphysis Body Angle Ramus Coronoid Process Condylar Process Dentoalveolar segment Based on the presence or absence of teeth- Kazanjian and Converse. Class I - Teeth present on either side of fracture fragment Class II- Teeth present on only one side of fracture fragment Class III- The patient is edentulous. www.indiandentalacademy.com
- 8. Horizontally Favourable Vertically Favourable Horizontally Unfavourable www.indiandentalacademy.com Vertically Unfavourable
- 9. Horizontally Favourable Vertically Favourable Horizontally Unfavourable www.indiandentalacademy.com Vertically Unfavourable
- 10. Favourable and Unfavourable Fractures of mandible www.indiandentalacademy.com
- 11. Clinical features Change in occlusion Anesthesia, paresthesia or dysesthesia. Abnormal mandibular movements Change in facial contour and mandibular arch form Laceration, Hematoma and Echymosis Loose teeth and crepitation on palpation Dolor, Tumor, Ruber and Color www.indiandentalacademy.com
- 12. Radiographic Examination Panoramic view Lateral oblique view Posterioanterior view Occlusal view Periapical view Reverse Towne’s view Temperomandibular view Computed tomography www.indiandentalacademy.com
- 13. MANAGEMENT • CLOSED REDUCTION • IMF- arch bars - dental wiring (direct, eyelet, multiple loop, risdon’s wiring) - cap splints in children - gunning splint - Bonded Brackets • OPEN REDUCTION - RIGID INTERNAL FIXAITON DCP, EDCP, lag screws, ASIF plates - SEMI RIGID FIXATION transosseous wiring, Champey’s mini-plates www.indiandentalacademy.com
- 14. Indications of closed reduction Nondisplaced favorable fractures Grossly comminuted fractures Fractures exposed with significant loss of overlying soft tissues Edentulous mandibular fractures Mandibular fractures in children Coronoid process fracture Condylar fracture www.indiandentalacademy.com
- 15. Choice of Method 1. Fracture pattern 2. Skill of the operator 3. Resources Available 4. General medical condition of the patient 5. Presence of other injuries 6. Degree of local contamination and infection 7. Associated soft tissue injury www.indiandentalacademy.com
- 16. Closed reduction and indirect skeletal fixation- different methods Direct interdental wiring (Gilmer) Indirect interdental wiring (eylet or Ivy loop) Continuous or multiple loop wiring Arch bars Cap splints Gunning type splints Pin fixation www.indiandentalacademy.com
- 17. Direct dental wiring (Gilmer wiring) www.indiandentalacademy.com
- 19. Eye let wiring (Ivy loop) www.indiandentalacademy.com
- 22. Different types of Arch bars www.indiandentalacademy.com
- 26. Indications for Open reduction Displaced unfavorable fracture through the angle Displaced unfavorable fracture of the body Multiple fractures of the facial bones Multiple # and Displaced Bilateral condylar # Fracture of an edentulous mandible with severe displacement Edentulous maxilla opposing fractured mandible www.indiandentalacademy.com
- 27. Open reduction and Direct skeletal fixation- Different methods Transosseous wiring Bone plating Intermedullary pinning Lag screws Titanium mesh Circumferential straps Bone clamps and Staples www.indiandentalacademy.com
- 30. Champy’s line of osteosynthesis www.indiandentalacademy.com
- 31. www.indiandentalacademy.com External Pin Fixation (Ext. Fixator)
- 35. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com