oral and maxillosurgeon versus plastic surgeons

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  • #11914
    doc_sumit
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    Registered On: 26/02/2012
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    dear frnds,

    are platic surgeon efficeint enough to treat facial fractures without knowledge of occlusion.many juss fix the bone and leaves occlusion on god to treat.is it justified on their part to refer patient to dentist after treating fractures and saying now occlsuion is dental prob so go to dentist but actually the prob lies in the fixation..”OCCLUSION IS KEY TO REDUCTION” we as a dental knows this but not the platic surgeons…so we should all work towards this so that common man can be awared abt this that the right personal to treat is the oral and maxillofacial surgeons and not the plastic surgeons….

    am i right ???????

    #17123
    Anonymous

    Mandible fractures are a frequent injury because of the mandible’s prominence and relative lack of support. As with any facial fracture, consideration must be given for the need of emergency treatment to secure the airway or to obtain hemostasis if necessary before initiating definitive treatment of the fracture.
    The use of preoperative and perioperative antibiotics in the treatment of mandible fractures, especially in the dentate portion is well established to reduce the risk of infection.

    CLOSED REDUCTION
    can be achieved using Erich s arch bars and circumdental wiring,, Ivy loops,, Bridle wiring,,
    A variety of wiring techniques (eg, Essig wire, continuous-loop [Stout] wiring) besides those mentioned above has been used for closed reduction and intermaxillary fixation.

    OPEN REDUCTION
    Wire osteosynthesis
    This is rarely used for definitive fixation since the advent of rigid fixation.[54] However, it may be useful for help in alignment of fractured segments prior to rigid fixation.#
    This can be placed either by an intraoral or extraoral route. The wire should be a prestretched soft stainless steel.#
    A straight wire can be used across the fracture site. This is placed so the direction of pull of the wire is perpendicular to the fracture site. This can be placed as a monocortical or bicortical wire.
    A figure-of-8 wire can provide increased strength at the superior and inferior borders compared to the straight wire.These can be achieved by either of the following approaches such as submandibular approach, pre-auricular approach or retromandibular approach

    #17124
    Drsumitra
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    Registered On: 06/10/2011
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    CLOSED REDUCTION IN PARTIALLY EDENTULOUS PATIENTS
    If a patient is partially dentate, the existing partial denture can be used for intermaxillary fixation. The partial dentures can be secured to either jaw using circummandibular or circumzygomatic wiring techniques. If the patient has no existing partial denture, acrylic blocks also can be fabricated with an incorporated arch bar and secured with circummandibular or circumzygomatic wires.

    CLOSED REDUCTION IN EDENTULOUS PATIENTS
    If dentures are available, they can be secured with circummandibular wires, circumzygomatic wires, or palatal screws.
    Dentures also can be fabricated with incorporated arch bars as well as a space in the anterior for feeding (Gunning splint). They are secured in the same fashion with circummandibular wires, circumzygomatic wires, or palatal screws.
    Biphasic pin fixation (external pin fixation or Joe Hall Morris appliance) also is used for edentulous patients. Its indications for use are as follows:
    -edentulous patients with a discontinuity defect because of either severe trauma or resectionn -severely comminuted fractures
    -When intermaxillary or rigid fixation cannot be used
    Biphasic pin fixation using two pins on both the proximal and distal fragments

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