The treatment of accidental injury (
trauma)
The trauma of the face consists of the soft tissue injuries and fractures of the skull. The soft tissue injuries caused mainly by traffic and sports injuries as well as by acts of brutality. In most cases it is, however, multiple injuries, with both the soft tissues, as well as the bones are affected.
What are the most common forms of injury?
The fractures of the face are in the levels described by LeFort I, II and III (Fig. 1), also include the zygomatic bone, orbital floor and nasal bone fractures among the most common fractures of the skull bone. The lower jaw has to depend on the use of force is very varied range of fracture types, ranging from the isolated mandible fracture up to the comminuted fracture (Fig. 2).
Figure 1: profiles of the fault lines in the middle face after LeFort
Figure 2: osteosynthesis plates supplied with mandibular fractures
Most likely to break below the lower jaw joint, because he is there the least (Fig. 3). In the past, the middle face fractures were stabilized with wire ligatures or wire hangers, which were guided by the facial soft tissues. 
Today carried the fracture restorations usually surgically, ie, miniaturized, adapted to the facial skeleton, osteosynthesis plates used and the billings for the shares to bone back together (Fig. 4).
Figure 3: Typical condylar
Figure 5: midface fracture osteosynthesis plates supplied in the x-ray
What material is used for the implants?
As the fixation device made from titanium, which is the most tolerable metal, you can leave the plates in most cases. Again, such a reconstruction is, however, from inside to outside, ie from the deeper bone injuries towards the closure of the soft tissues that are supplied with atraumatic sutures to remain low or no scars. Most of these interventions can, thanks to long and slender, the facial skeleton instruments adapted from the mouth of an operation.
With broken nose always immediately to the doctor
The nasal bone fractures (Fig. 6) have the best therapeutic results, when possible short supplies after the trauma, as the fracture of the shares are still mobile and can then be reduced slightly. The operation of the nasal bone fracture occurs when there are no soft tissue injuries, from the nostrils inside. Subsequently, the nasal splint with a pin (Fig. 7) for 6 to 8 days and apart from some bruising and then restored.
Figure 6: saddle nose after trauma
Figure 7: Schienungssplint after nose surgery
The zygomatic bone, orbital floor (Fig. 9), caused by trauma to the eye socket, are subject to special attention, as will be moved by such traumas as the eye in its axis and will there be double vision, the binocular, two-dimensional look affect. In addition, a cheekbone fracture, damage to the second branch of the trigeminal nerve moves by itself and causes facial asymmetry. For these reasons must always be treated surgically after appropriate X-ray diagnosis of such injuries. Here, the orbital floor reconstructed and reattached the cheekbone after anatomic reduction using internal fixation.
Figure 9: zygomatic fracture
Tooth fractures and tooth loss
A special case of facial injuries are the front tooth trauma, in which the violence of whatever kind exposed front teeth are affected (punch, bike or sports injury).
It will be through the use of force, the affected teeth dislocated in various ways, that is relaxed and the damaged periodontium with also. From the easy dislocation to total tooth loss, there are all transitions. In the anterior trauma is attempted in each case, to get your own teeth. The teeth can be stabilized by a splint that will keep for about 4 to 6 weeks, until the teeth are healed back firmly into the jaw. The teeth were completely fallen out, they must first be supplied endodontic root canals and then the teeth are repositioned and splinted. If, however, fractured teeth and replantation itself no longer possible, we shall replace the teeth with dental implants
