Trauma Maxillary fractures Flashcards
What is the definition of periodontal concussion?
Injury to the periodontium resulting in sensitivity to
percussion without loosening or displacement of the tooth
What is the definition of periodontal subluxation?
Injury to the periodontium resulting in loosening of the tooth without tooth displacement
What is the definition of periodontal luxation?
Injury to the supporting structures of a tooth resulting in loosening and clinical or radiographic displacement Luxation can be extrusive, intrusive, mesial, distal, buccal, or lingual.
What is the most commonly avulsed tooth?
Maxillary central incisor due to its vulnerability as the most
anteriorly positioned tooth in either arch (presuming a
normal occlusal relationship)
What physiologically compatible solutions are best for storing avulsed teeth?
Hank’s balance salt solution, ViaSpan, milk, saliva, saline
What arteries contribute to the primary blood
supply of the maxilla?
● Internal maxillary artery
● Ascending pharyngeal artery
● Ascending palatine branch of the facial artery
What is the most common complication associated with maxillary fractures?
Hemorrhage, which may be self-limiting but may require nasal packing for control
What test should be performed in a patient who develops delayed intermittent epistaxis following severe midface trauma?
Angiography to evaluate for aneurysms or pseudoaneurysms that can result in immediate or delayed postoperative bleeding
Describe a Le Fort I fracture.
A Le Fort I fracture is a horizontal fracture of the maxilla extending through the nasal septum, lateral nasal walls, lateral maxillary sinus walls, extending posteriorly to the pterygomaxillary junction. The fracture involves the nasomaxillary, zygomaticomaxillary, and pterygomaxillary vertical buttresses of the face.
Describe a Le Fort II fracture.
A Le Fort II fracture is a pryramidal fracture involving the nasofrontal suture, medial and inferior orbital walls, zygomaticomaxillary suture, lateral maxillary sinus walls,
and the pterygomaxillary junction.
Describe a Le Fort III fracture.
A Le Fort III fracture is a craniofacial dysjunction; the fracture passes through the nasofrontal suture, frontal process of
the maxilla, lacrimal bones, ethmoid sinus, and lamina
papyracea. It then extends across the orbital floor to the inferior orbital fissure. From this point, it extends in three directions: across the lateral orbital wall through the zygomaticofrontal suture, through the zygomatic arch, and through the pterygoid plates.
Describe a palatal split fracture.
A palatal split fracture begins anteriorly at the anterior pyriform aperture and extends posteriorly to the posterior aspect of the hard palate. Palatal fractures are more likely to manifest as true sagittal palatal split fractures in pediatric patients because of an unfused midpalatal suture. Para-sagittal palatal fractures are more common in adults because this is the area where the palatal bone is the thinnest.
What is a Gunning splint?
A Gunning splint is a plate fabricated to the existing
edentulous ridge with arch bars or suspension brackets used to establish intermaxillary fixation in edentulous or partially edentulous patients.
In complicated palatal fractures with bone loss or severe comminution, what can be used to maintain the palatal arch?
Dental splints created from premorbid impressions or
dentures (in edentulous patients)
What structures make up the vertical buttresses of
the midface?
● Three paired buttresses: Zygomaticomaxillary (lateral), nasomaxillary (medial), pterygomaxillary (posterior)
● Single unpaired structure: Septovomerian buttress (midline)
