Bone Injuries of the Maxillofacial Region
Fractures of the bones of the
face are treated in a manner similar to the fractures in other parts of the body.
The specific form of treatment is determined by various factors, which include the
location of the fracture, the severity of the fracture, the age and general health
of the patient. When an arm or a leg is fractured, a cast is often applied to stabilize
the bone to allow for proper healing. Since a cast cannot be placed on the face,
other means have been developed to stabilize facial fractures.
One of these options involves wiring the jaws together for certain fractures of
the upper and/or lower jaw. Certain other types of fractures of the jaw are best
treated and stabilized by the surgical placement of small plates and screws at the
involved site. This technique of treatment can often allow for healing and obviates
the necessity of having the jaws wired together. This technique is called "rigid
fixation" of a fracture. The relatively recent development and use of rigid fixation
has profoundly improved the recovery period for many patients, allowing them to
return to normal function more quickly.
The treatment of facial fractures should be accomplished in a thorough and predictable
manner. More importantly, the patient's facial appearance should be minimally affected.
An attempt at accessing the facial bones through the fewest incisions necessary
is always made. At the same time, the incisions that become necessary, are designed
to be small and, whenever possible, are placed so that the resultant scar is hidden.
Injuries to the Teeth and Surrounding Dental Structures
Isolated injuries to teeth are
quite common and may require the expertise of various dental specialists. Oral surgeons
usually are involved in treating fractures in the supporting bone or in replanting
teeth that have been displaced or knocked out. These types of injuries are treated
by one of a number of forms of splinting (stabilizing by wiring or bonding teeth
together).
If a tooth is knocked out, it should be placed in salt water or
milk. The sooner the tooth is re-inserted into the dental socket, the
better chance it will survive. Therefore, the patient should see a dentist or oral
surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants
of the ligament that hold the tooth in the jaw are attached and are vital to the
success of replanting the tooth. Other dental specialists may be called upon such
as endodontists, who may be asked to perform root canal therapy, and/or restorative
dentists who may need to repair or rebuild fractured teeth. In the event that injured
teeth cannot be saved or repaired, dental implants are often now utilized as replacements
for missing teeth.